Individual provider Active NPI

Harold Acosta, DMD

  • Dentist
  • Orlando, FL
National Provider Identifier
1679883441
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN18727 Issued in FL
Practice address
4426 Old Winter Garden Rd
Orlando, FL 32811-4211
Phone
(407) 428-5751
NPI assigned
Oct 14, 2010
Last updated
Dec 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN18727 FL Primary

Addresses

Primary practice location

4426 Old Winter Garden Rd
Orlando, FL 32811-4211

Mailing address

14099 Larkspur Lake Dr
Winter Garden, FL 34787-0089
Phone (954) 857-9687

Other practice location 1

232 N Orange Blossom Trl
Orlando, FL 32805-1612
Phone (407) 428-5751

Other identifiers 1

IdentifierTypeStateIssuer
101816800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220823001585 FL Practitioner - Dentist 9133412018 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN18727FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Center for the Homeless Inc Current Accepting new patients
Health Care Center for the Homeless, Inc. CurrentSince May 20, 2022 Accepting new patients

Locations

232 N Orange Blossom Trl
Orlando, FL 32805

4426 Old Winter Garden Rd
Orlando, FL 32811
Phone (407) 428-1672

Networks

  • Freedom Health HMO Network

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": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1679883441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14099 LARKSPUR LAKE DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347870089",
            "telephone_number": "954-857-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4426 OLD WINTER GARDEN RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328114211",
            "telephone_number": "407-428-5751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 N Orange Blossom Trl",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328051612",
            "country_code": "US",
            "telephone_number": "407-428-5751",
            "fax_number": "407-428-6204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "HAROLD",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2023-12-22",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101816800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.