John A Acosta, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3118 Issued in MS

Practice address

7734 Airways Blvd
Southaven, MS 38671-5306

Phone

(662) 349-3838

Fax

(662) 349-5923

NPI assigned

Dec 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• PDC of Memphis 3 PLLC

  • Pediatric Dentistry
  • Memphis, TN
  • NPI 1063387652
  NPD Authorized official
• Pediatric Dental Associates PLLC

  dba Pediatric Dental Associates

  • Pediatric Dentistry
  • Memphis, TN
  • NPI 1851954903
  NPD Authorized official
• Pediatric Dental Care of Memphis, PLLC

  • Pediatric Dentistry
  • Memphis, TN
  • NPI 1598481764
  NPD Authorized official
• Dormois & Fuson, P.L.L.C.

  dba Pediatric Dental Group

  • Pediatric Dentistry
  • Southaven, MS
  • NPI 1639235963
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841356169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7734 AIRWAYS BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715306",
            "telephone_number": "662-349-3838",
            "fax_number": "662-349-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7734 AIRWAYS BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715306",
            "telephone_number": "662-349-3838",
            "fax_number": "662-349-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MS",
            "license": "3118",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "7024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8088",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN PROVIDER",
            "identifier": "3153834",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• A & D Behavioral Solutions LLC
• A Mothers Love Home Care
• Abc Pediatric Therapy of Mississippi, LLC
• Abide Endodontics
• Andrew Elias Abide Jr., DMD
• Kayla E Adair, OTR/L
• Amanda Vance Adams, BSN RN
• Tara Adams, P-LPC
• Pradeep Adatrow, DDS
• Addiction Campuses of Mississippi, LLC (Woodland Recovery Center)

• Pediatric Dentistry in Southaven, MS
• Providers in Southaven, MS by specialty
• Pediatric Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.