Active NPI
Luis Gustavo Acosta, DDS.
- Dentist
- Santa Clarita, CA
National Provider Identifier
1952820607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS105742
- Practice address
- 27661 Bouquet Canyon Rd
Santa Clarita, CA 91350-1793 - Phone
- (661) 347-0031
- NPI assigned
- Sep 13, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 60745075 | WA | |
| Dentist | 122300000X | DDS105742 | CA | Primary |
Addresses
Primary practice location
27661 Bouquet Canyon Rd
Santa Clarita, CA 91350-1793
Mailing address
27661 Bouquet Canyon Rd
Santa Clarita, CA 91350-1793
Phone (661) 347-0031
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS105742 | CA | MD | Dentist |
| 60745075 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington Dental Corporation, PC | Past | Accepting new patients |
Interoperability endpoints
- luis.acostadds.p1@direct.jwch.nextgenshare.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Lacey Modern Dentistry
- General Practice Dentistry
- Lacey, WA
- NPI 1992183339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669161600000",
"number": "1952820607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27661 BOUQUET CANYON RD",
"city": "SANTA CLARITA",
"state": "CA",
"postal_code": "913501793",
"telephone_number": "661-347-0031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27661 BOUQUET CANYON RD",
"city": "SANTA CLARITA",
"state": "CA",
"postal_code": "913501793",
"telephone_number": "661-347-0031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACOSTA",
"first_name": "LUIS",
"middle_name": "GUSTAVO",
"name_prefix": "Dr.",
"credential": "DDS.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-13",
"last_updated": "2022-11-23",
"certification_date": "2022-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "60745075",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS105742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Clarita, CA
- Maria Isabel Abundis-Barrera, M.D.
- Access One Home Care Services Inc.
- Accesscare Home Health Services LLC (Accesscare Home Health Services)
- Julie Lynn Acebedo
- Arianna Noelle Acosta
- Action Family Counseling - SCV Inc
- Action Family Counseling the Ranch
- Active Lifestyle Healthcare, Inc.
- Georgia Adams, LMT
- Judith S Adams, C-ANP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.