Provider Demographics
NPI:1376658278
Name:COSBY, JOYCE YVETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:YVETTE
Last Name:COSBY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 CANDLER ROAD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032
Mailing Address - Country:US
Mailing Address - Phone:404-288-8880
Mailing Address - Fax:404-288-2006
Practice Address - Street 1:2445 CANDLER ROAD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032
Practice Address - Country:US
Practice Address - Phone:404-288-8880
Practice Address - Fax:404-288-2006
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN 11641122300000X
FLDN 8809122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00756852Medicaid
FL0749729Medicaid
AC9735323OtherDEA