NPIMap

Organization Active NPI

Adrian Acosta DDS a Professional Dental Corp

  • General Practice Dentistry
  • Irvine, CA
National Provider Identifier
1003548173
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ADRIAN ACOSTA DDS A PROFESSIONAL DENTAL CORP
Practice address
113 Waterworks Way
355
Irvine, CA 92618-1367
Phone
(562) 356-0948
Fax
(866) 817-3581
NPI assigned
Jun 28, 2022
Organization subpart
Yes
Parent organization
ADRIAN ACOSTA DDS A PROFESSIONAL DEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alan Boval
Title
Chief Executive Officer
Phone
(562) 356-0948

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

113 Waterworks Way
355
Irvine, CA 92618-1367

Mailing address

901 W. Whittier Blvd
La Habra, CA 90631-3743
Phone (562) 356-0948

Other names 1

  • Gold Coast Dental Irvine Specialty Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Diane Boval DDS a Professional Dental Corp29 organizations share this tax ID, including this one
Part of
Diane Boval DDS a Professional Dental Corp

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1003548173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W. WHITTIER BLVD",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313743",
            "telephone_number": "562-356-0948",
            "fax_number": "866-817-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY",
            "address_2": "355",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926181367",
            "telephone_number": "562-356-0948",
            "fax_number": "866-817-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADRIAN ACOSTA DDS A PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADRIAN ACOSTA DDS A PROFESSIONAL DE",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "BOVAL",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "562-356-0948"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gold Coast Dental Irvine Specialty Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.