Eduardo Alonso Acosta, DDS
Individual provider Active NPI General Practice Dentistry · Dodge City, KS
NPI 1043945207 · NPPES record last updated Jan 27, 2026
Key facts
- NPI
- 1043945207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 62300 (KS)
- Practice address
- 2306 1St Ave
Dodge City, KS 67801-2527 - Phone
- (620) 225-5154
- Fax
- (620) 371-8870
- NPI assigned
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220825000987 | TX | Order and Referring Only - Dentist |
1355725391 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62300 | KS | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Avenue Dental, P.a. | General Practice | Past |
Accepting new patients |
| First Avenue Dental, P.a. | General Practice | Past |
Accepting new patients |
| First Dental Garden City, LLC | Past |
Accepting new patients | |
| Maple Dental, LLC | General Practice | Past | Accepting new patients |
Interoperability endpoints
- eduardo.acosta.p1@direct.centromed.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 62300 | KS | Yes |
Addresses
Primary practice location
2306 1St Ave
Dodge City, KS 67801-2527
Mailing address
2306 1St Ave
Dodge City, KS 67801-2527
Phone (620) 225-5154
Other practice location 1
1502 Harding Ave Ste 9
Garden City, KS 67846-4700
Phone (620) 277-9330
Other practice location 2
307 N Main St
Ulysses, KS 67880-2132
Phone (620) 356-1221
Other practice location 3
23 E 11th St
Liberal, KS 67901-2720
Phone (620) 604-9279
Other providers in Dodge City, KS
- Karen M Ackerman
- Richard J Ackerman Jr.
- Alfredo Acosta
- Tanya Lynn Acosta
- Andrew Joseph Adams
- Advanced Health Services, LLC
- Advanced Home Health Care, LLC
- Advanced Orthopedic and Sports Medicine
All providers in Dodge City, KS · General Practice Dentistry in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.