Andreina Gabriela Acconciagioco, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

41057 Issued in TX

Practice address

2830 W Grande Blvd Apt 14306
Tyler, TX 75703-3595

Phone

(346) 320-8547

NPI assigned

Feb 5, 2024

Last updated

Oct 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1376306027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183550",
            "telephone_number": "617-358-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 W GRANDE BLVD APT 14306",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033595",
            "telephone_number": "346-320-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACCONCIAGIOCO",
        "first_name": "ANDREINA",
        "middle_name": "GABRIELA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "41057",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Tyler, TX
• Providers in Tyler, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.