Barry Edward Aller, D.D.S.
Individual provider Active NPI General Practice Dentistry · Poway, CA
NPI 1255460564 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1255460564
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 21843 (CA)
- Practice address
- 15644 Pomerado Rd
#101
Poway, CA 92064-2400 - Phone
- (858) 487-5521
- NPI assigned
- Mar 4, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160317002360 | CA | Order and Referring Only - Oral Surgery |
2062719073 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21843 | CA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 21843 | CA | Yes |
Addresses
Primary practice location
15644 Pomerado Rd
#101
Poway, CA 92064-2400
Mailing address
15644 Pomerado Rd
#101
Poway, CA 92064-2400
Phone (858) 487-5521
Other providers in Poway, CA
- Aaron Alexander
- Alireza
- Alyssa Lynn Allen
- Lauren Allen
- Lydia Allen
- Gavin Shaun Allicock-Lim
- Erika Terry Allred
- Demah Alobaidi
- Julio Hector Alonso
- Margarita M Alonso
All providers in Poway, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.