Active NPI
Barry G Acker DDS PA
- Oral and Maxillofacial Surgery (Dentist)
- Tyler, TX
National Provider Identifier
1124393434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 8636
- Legal business name
- BARRY G ACKER DDS PA
- Practice address
- 3100 New Copeland Rd
Tyler, TX 75701-7940 - Phone
- (903) 597-2848
- Fax
- (903) 593-9626
- NPI assigned
- Mar 20, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Barry G Acker
- Title
- President/Owner
- Phone
- (903) 597-2848
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 8636 | TX | Primary |
Addresses
Primary practice location
3100 New Copeland Rd
Tyler, TX 75701-7940
Mailing address
3100 New Copeland Rd
Tyler, TX 75701-7940
Phone (903) 597-2848
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4521923 | Other | TX | AETNA |
| 120698902 | Medicaid | TX | |
| 120698906 | Medicaid | TX | |
| 844377 | Other | TX | UNITED CONCORDIA |
National Provider Directory
National Provider DirectoryLocations
3100 New Copeland Rd
Tyler, TX 75701
Phone (903) 597-2848
2550 Elkton Trl
Tyler, TX 75703
Phone (903) 534-1414
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Oral and Maxillofacial Surgery (Dentist)
- Tyler, TX
- NPI 1841219342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332201600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1332201600000",
"number": "1124393434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 NEW COPELAND RD",
"city": "TYLER",
"state": "TX",
"postal_code": "757017940",
"telephone_number": "903-597-2848",
"fax_number": "903-593-9626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 NEW COPELAND RD",
"city": "TYLER",
"state": "TX",
"postal_code": "757017940",
"telephone_number": "903-597-2848",
"fax_number": "903-593-9626"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BARRY G ACKER DDS PA",
"organizational_subpart": "NO",
"enumeration_date": "2012-03-20",
"last_updated": "2012-03-20",
"status": "A",
"authorized_official_last_name": "ACKER",
"authorized_official_first_name": "BARRY",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "903-597-2848"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "TX",
"license": "8636",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4521923",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120698902",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120698906",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "844377",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.