Individual provider Active NPI

Cristina Maria Hernandez Acosta, DDS

  • Dentist
  • Greensboro, NC
National Provider Identifier
1255731246
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12569 Issued in NC
Practice address
2733 Horse Pen Creek Rd Ste 107
Greensboro, NC 27410-8538
Phone
(336) 854-9270
NPI assigned
Aug 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 20922 FL
Dentist 122300000X 12569 NC Primary

Addresses

Primary practice location

2733 Horse Pen Creek Rd Ste 107
Greensboro, NC 27410-8538

Mailing address

10510 NW 74TH St Unit 303
Medley, FL 33178-2470
Phone (415) 622-5036

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

State licenses

LicenseStateTypeSpecialty
12569NCMDProfessional Counselor
DN 20922FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
William B Gross DDS of Greensboro LLC CurrentSince Jul 9, 2023 Accepting new patients
Douglas a Kellogg DDS PA PastSince Jul 9, 2023 Accepting new patients

Locations

2733 Horse Pen Creek Rd
Ste 107
Greensboro, NC 27410
Phone (336) 854-9270

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1255731246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10510 NW 74TH ST UNIT 303",
            "city": "MEDLEY",
            "state": "FL",
            "postal_code": "331782470",
            "telephone_number": "415-622-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2733 HORSE PEN CREEK RD STE 107",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274108538",
            "telephone_number": "336-854-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ ACOSTA",
        "first_name": "CRISTINA",
        "middle_name": "MARIA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 20922",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "12569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2023; 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.