NPIMap

Individual provider Active NPI

Corey Robert Acree, DDS

  • Dentist
  • Modesto, CA
National Provider Identifier
1043317944
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
48870 Issued in CA
Practice address
1213 Coffee Rd
Suite B
Modesto, CA 95355-4229
Phone
(209) 529-0674
Fax
(209) 529-1437
NPI assigned
Sep 20, 2006
Last updated
Dec 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 48870 CA Primary

Addresses

Primary practice location

1213 Coffee Rd
Suite B
Modesto, CA 95355-4229

Mailing address

1213 Coffee Rd
Suite B
Modesto, CA 95355-4229
Phone (209) 529-0674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Corey R. Acree DDS, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1043317944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 COFFEE RD",
            "address_2": "SUITE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554229",
            "telephone_number": "209-529-0674",
            "fax_number": "209-529-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 COFFEE RD",
            "address_2": "SUITE B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554229",
            "telephone_number": "209-529-0674",
            "fax_number": "209-529-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACREE",
        "first_name": "COREY",
        "middle_name": "ROBERT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; 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.