Acosta, John A
Acosta, John A is an individual health care provider with primary practice located at 7734 Airways Blvd , Southaven MS 38671-5306. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Acosta, John A can be contacted via phone (662) 349-3838.Contact Information
Primary practice address
7734 Airways Blvd
Southaven MS 38671-5306
Phone: (662) 349-3838
Fax: (662) 349-5923
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Pediatric Dentistry | 1223P0221X | 3118 | Mississippi |
Dental Providers / Pediatric Dentistry | 1223P0221X | 7024 | Tennessee |
Profile Details
NPI number | 1841356169 |
---|---|
LBN Legal business name | Acosta, John A |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 29th, 2006 |
Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1841356169 | NPPES |
Tennessee | Other | 3153834 | BCBS TN PROVIDER |
Tennessee | MEDICAID | 8088 | BCBS TN PROVIDER |
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