Corey Acosta, DDS
Dentist, Pediatric Dentistry in Memphis, TN. Individual provider (NPI-1).
NPI number1376126870
StatusActive
Last updated in NPPESJun 2, 2023
Details
- NPI
- 1376126870
- Entity type
- Individual (NPI-1)
- Name
- Corey Acosta
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 3, 2021
- Certification date
- Jun 2, 2023
- Last updated
- Jun 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | 11562 | TN | Yes |
| 122300000X | Dentist | 11562 | TN | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | TN |
Practice location
6611 Kirby Center CvMemphis, TN 38115-4313
Phone 901-363-8192
Mailing address
717 S White Station Rd Ste 7Memphis, TN 38117-4538
Phone 901-692-1404
Other practice locations
717 S White Station Rd Ste 7
Memphis, TN 38117-4538
Memphis, TN 38117-4538
Phone 901-363-8192
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