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General NPI Number Information
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NPI Number | 1679152185
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Entity Type | Individual
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Provider Name | JOANNA MARIE S. ACOSTA-SASSOON DDS
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Gender | Female
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Dates
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Enumeration Date | 04/03/2021
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 4867 BAXTER RD STE 101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-4469
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Country | US
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Telephone | 757-499-8139
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Fax | 757-473-8816
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Provider Business Mailing Address
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Address Line | 805 ANTONICK LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-1765
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Country | US
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Telephone | 757-407-3164
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17285
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401416602
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License Number State | VA
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