Active NPI
Cecelia Acosta-Lake, DDS
- Dentist
- Bronx, NY
National Provider Identifier
1760484331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 051325
- Practice address
- 1894 Walton Ave
Bronx, NY 10453-6018 - Phone
- (718) 583-3060
- NPI assigned
- Aug 12, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 051325 | NY | Primary |
Addresses
Primary practice location
1894 Walton Ave
Bronx, NY 10453-6018
Mailing address
1894 Walton Ave
Bronx, NY 10453-6018
Phone (718) 583-3060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051325 | Other | NY | LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051325 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1760484331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1894 WALTON AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104536018",
"telephone_number": "718-583-3060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1894 WALTON AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104536018",
"telephone_number": "718-583-3060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACOSTA-LAKE",
"first_name": "CECELIA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-12",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "051325",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "051325",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.