Breanna Michele Costa, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10294 Issued in TN

Practice address

264 S Peters Rd
Knoxville, TN 37923-5203

Phone

(865) 539-1776

NPI assigned

Aug 28, 2016

Last updated

Jun 16, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Malone & Costa, PLLC

  • General Practice Dentistry
  • Knoxville, TN
  • NPI 1174183990
  NPD (past)
• True Dental of Hixson

  • Dental Clinic/Center
  • Hixson, TN
  • NPI 1184345993
  NPD (past)

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1811443153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 WESTLAND GARDENS BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379225306",
            "telephone_number": "423-596-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 S PETERS RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235203",
            "telephone_number": "865-539-1776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4513 Hixson Pike",
            "address_2": "# 103",
            "address_purpose": "LOCATION",
            "city": "Hixson",
            "state": "TN",
            "postal_code": "373435039",
            "country_code": "US",
            "telephone_number": "423-875-6778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COSTA",
        "first_name": "BREANNA",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb Corwin, PH.D.
• Emily Corwin, PH.D
• Cree Cosby, FNP
• Rhaven Alyson Cosby, COTA/L
• Cosmetic Dentistry of Knoxville
• Michael J Costa Jr., DDS
• Briana Teresa Costello, M.D.
• Connie Michell Costello
• Jason Costner
• Seaira Brianna Cota, R.N.

• General Practice Dentistry in Knoxville, TN
• Providers in Knoxville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.