Michael Angelo Acosta Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23987 Issued in CA

Practice address

10200 Riverside Dr Ste 204
Toluca Lake, CA 91602-2539

Phone

(818) 766-5175

Fax

(818) 843-7645

NPI assigned

May 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982817516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 RIVERSIDE DR STE 204",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022539",
            "telephone_number": "818-766-5175",
            "fax_number": "818-843-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 RIVERSIDE DR STE 204",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022539",
            "telephone_number": "818-766-5175",
            "fax_number": "818-843-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "MICHAEL",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "23987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Toluca Lake, CA
• Providers in Toluca Lake, CA by specialty
• General Practice Dentistry in California

• 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.