Individual provider Active NPI

Joanna Marie S. Acosta-Sassoon, DDS

  • General Practice Dentistry
  • Virginia Beach, VA
National Provider Identifier
1679152185
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401416602 Issued in VA
Practice address
4867 Baxter Rd Ste 101
Virginia Beach, VA 23462-4469
Phone
(757) 499-8139
Fax
(757) 473-8816
NPI assigned
Apr 3, 2021
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17285 MD
General Practice Dentistry 1223G0001X 0401416602 VA Primary

Addresses

Primary practice location

4867 Baxter Rd Ste 101
Virginia Beach, VA 23462-4469

Mailing address

805 Antonick LN
Virginia Beach, VA 23464-1765
Phone (757) 407-3164

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
0401416602VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Dental Studio PLLC CurrentSince Jun 23, 2025 Accepting new patients
Sareen Dental P.C General Practice PastSince Dec 1, 2023 Accepting new patients

Locations

4867 Baxter Rd
Ste 101
Virginia Beach, VA 23462
Phone (757) 499-8139

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1679152185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 ANTONICK LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234641765",
            "telephone_number": "757-407-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4867 BAXTER RD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624469",
            "telephone_number": "757-499-8139",
            "fax_number": "757-473-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA-SASSOON",
        "first_name": "JOANNA MARIE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-03",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "17285",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.