Active NPI
Adolfo J Barrera, D.D.S
- Pediatric Dentistry
- Campbell, CA
National Provider Identifier
1215063029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 38031
- Practice address
- 40 Jeffers Way
Campbell, CA 95008-2891 - Phone
- (408) 871-2885
- Fax
- (408) 871-2842
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 38031 | CA | Primary |
Addresses
Primary practice location
40 Jeffers Way
Campbell, CA 95008-2891
Mailing address
40 Jeffers Way
Campbell, CA 95008-2891
Phone (408) 871-9658
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200581780 | Other | CA | TAX ID# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38031 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243987200000",
"number": "1215063029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 JEFFERS WAY",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950082891",
"telephone_number": "408-871-9658",
"fax_number": "408-871-2842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 JEFFERS WAY",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950082891",
"telephone_number": "408-871-2885",
"fax_number": "408-871-2842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARRERA",
"first_name": "ADOLFO",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2009-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "38031",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID#",
"identifier": "200581780",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Campbell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.