Individual provider Active NPI

Barry Edward Aller, D.D.S.

  • General Practice Dentistry
  • Poway, CA
National Provider Identifier
1255460564
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21843 Issued in CA
Practice address
15644 Pomerado Rd
#101
Poway, CA 92064-2400
Phone
(858) 487-5521
NPI assigned
Mar 4, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21843 CA Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160317002360 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2062719073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21843CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255460564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15644 POMERADO RD",
            "address_2": "#101",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642400",
            "telephone_number": "858-487-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15644 POMERADO RD",
            "address_2": "#101",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642400",
            "telephone_number": "858-487-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLER",
        "first_name": "BARRY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "21843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.