John Andrew Acker, DMD

Individual provider Active NPI Dentist · Pensacola, FL

NPI 1376701953 · NPPES record last updated Jan 19, 2009

Key facts

NPI
1376701953
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
DN11019 (FL)
Practice address
4300 Bayou Blvd
Suite 11
Pensacola, FL 32503-1949
Phone
(850) 484-0960
Fax
(850) 484-9196
NPI assigned
May 30, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150729007161 FL Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
4587978044

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DN11019FLMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN11019 FL Yes

Addresses

Primary practice location

4300 Bayou Blvd
Suite 11
Pensacola, FL 32503-1949

Mailing address

4300 Bayou Blvd
Suite 11
Pensacola, FL 32503-1949
Phone (850) 484-0960

Other providers in Pensacola, FL

All providers in Pensacola, FL · Dentist in Florida

Sources for this page

Verify at the official NPI Registry.