Jeffrey Glen Allred, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

58336 Issued in CA

Practice address

955 Boardwalk
Suite 201
San Marcos, CA 92078-2659

Phone

(760) 304-6455

NPI assigned

Feb 10, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Allred Dental Corporation

  • Oral and Maxillofacial Surgery Clinic/Center
  • San Marcos, CA
  • NPI 1982351771
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1194964411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 BOARDWALK",
            "address_2": "SUITE 201",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782659",
            "telephone_number": "760-304-6455",
            "fax_number": "760-481-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 BOARDWALK",
            "address_2": "SUITE 201",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782659",
            "telephone_number": "760-304-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLRED",
        "first_name": "JEFFREY",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-10",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "7089890-9922",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pouyan Allahyari
• Brittany Allen-Robertson
• Simone Valencia Allen
• Stacey Lynn Allen, MT
• Allred Dental Corporation
• Joshua Almadin
• Alpha Physical Therapy and Performance, Inc
• Alta Vista Public Charter Inc.
• Leon Altamirano, PSY.D.
• Alternative Hospice Care Inc.

• Dentist in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.