Jose Guadalupe Acevedo, DDS
Individual provider Active NPI General Practice Dentistry · South Gate, CA
NPI 1831976901 · NPPES record last updated Sep 12, 2023
Key facts
- NPI
- 1831976901
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 109376 (CA)
- Practice address
- 8627 Atlantic Ave
South Gate, CA 90280-3501 - Phone
- (888) 499-9303
- NPI assigned
- Sep 12, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231030000982 | CA | Order and Referring Only - Dentist |
9436505328 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 109376 | CA | Yes |
Addresses
Primary practice location
8627 Atlantic Ave
South Gate, CA 90280-3501
Mailing address
104 S Spencer St
Dalton, GA 30721-3121
Phone (706) 618-3729
Other providers in South Gate, CA
- Abner Mahboobian Dental Corporation
- Mario Abrego
- Eric Acosta
- Action Medical Supply
- Habib Adib
- Advanced Care Orthopedics
- Mukul Aeri
All providers in South Gate, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.