Individual provider Active NPI

Oscar Alberto Lopez Acosta, D.D.S

  • Dentist
  • Yucaipa, CA
National Provider Identifier
1841584786
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60403 Issued in CA
Practice address
35762 Date Ave
Yucaipa, CA 92399-4011
Phone
(909) 763-8965
NPI assigned
Jun 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60403 CA Primary

Addresses

Primary practice location

35762 Date Ave
Yucaipa, CA 92399-4011

Mailing address

35762 Date Ave
Yucaipa, CA 92399-4011
Phone (909) 763-8965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160614002300 CA Order and Referring Only - DentistPractitioner - Dentist 8921399403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60403CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1841584786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35762 DATE AVE",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923994011",
            "telephone_number": "909-763-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35762 DATE AVE",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923994011",
            "telephone_number": "909-763-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ ACOSTA",
        "first_name": "OSCAR",
        "middle_name": "ALBERTO",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-08",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

Verify at the official NPI Registry.