Organization Active NPI

La Costa Dental of Kostoryz PA

  • Dentist
  • Corpus Christi, TX
National Provider Identifier
1245658798
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22334 Issued in TX
Legal business name
LA COSTA DENTAL OF KOSTORYZ PA
Practice address
4506 Kostoryz Rd
Corpus Christi, TX 78415-5023
Phone
(817) 531-3500
Fax
(817) 531-3501
NPI assigned
Apr 2, 2014
Last updated
Oct 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Authorized official

Name
Dr. Tien Dinh Phan, DMD
Title
Dentist
Phone
(956) 507-7253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 22334 TX Primary

Addresses

Primary practice location

4506 Kostoryz Rd
Corpus Christi, TX 78415-5023

Mailing address

3050 Regent Blvd Ste 110
Irving, TX 75063-3107
Phone (956) 507-7253

National Provider Directory

National Provider Directory

Locations

4506 Kostoryz Rd
Corpus Christi, TX 78415
Phone (361) 854-4000

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791417600000",
    "number": "1245658798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 REGENT BLVD STE 110",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633107",
            "telephone_number": "956-507-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4506 KOSTORYZ RD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784155023",
            "telephone_number": "817-531-3500",
            "fax_number": "817-531-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA COSTA DENTAL OF KOSTORYZ PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-02",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "TIEN",
        "authorized_official_middle_name": "DINH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "956-507-7253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "22334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; 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.