NPIMap

Organization Active NPI

Edwin Acosta DDS Inc

Doing business as Hancock Village Dental

  • Dentist
  • Clermont, FL
National Provider Identifier
1356767610
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19583 Issued in FL
Legal business name
EDWIN ACOSTA DDS INC
Doing business as
Hancock Village Dental
Practice address
2560 E Highway 50
Suite 103
Clermont, FL 34711-8411
Phone
(352) 989-5815
Fax
(321) 400-1176
NPI assigned
Mar 11, 2014
Last updated
Mar 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Authorized official

Name
Dr. Edwin Acosta, DDSNPI 1578729711
Title
President
Phone
(352) 989-5815

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19583 FL Primary

Addresses

Primary practice location

2560 E Highway 50
Suite 103
Clermont, FL 34711-8411

Mailing address

2560 E Highway 50
Suite 103
Clermont, FL 34711-8411
Phone (352) 989-5815

Other names 1

  • Hancock Village Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2560 E Highway 50
Ste 103
Clermont, FL 34711
Phone (352) 989-5185

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1356767610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 E HIGHWAY 50",
            "address_2": "SUITE 103",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118411",
            "telephone_number": "352-989-5815",
            "fax_number": "321-400-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 E HIGHWAY 50",
            "address_2": "SUITE 103",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118411",
            "telephone_number": "352-989-5815",
            "fax_number": "321-400-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWIN ACOSTA DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-989-5815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "19583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hancock Village Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.