Individual provider · NPI-1

Dr. Joseph Acquaviva III, DDS

Dentist, General Practice · Oklahoma City, OK

NPI number1609669274
StatusActive
Last updated in NPPESMay 27, 2025

Details

NPI
1609669274
Entity type
Individual (NPI-1)
Name
Dr. Joseph Acquaviva III
Credential
DDS
Sex
Male
Sole proprietor
Yes
Enumeration date
May 27, 2025
Certification date
May 27, 2025
Last updated
May 27, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice8012OKYes

Practice location

7130 W Hefner Rd
Oklahoma City, OK 73162-4502

Phone 405-595-0585

Mailing address

1216 Sw 156th Ter
Oklahoma City, OK 73170-4314

Phone 405-365-6575

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