Individual provider Active NPI

Faith-Roselle Roy Barreyro, DMD

  • General Practice Dentistry
  • La Jolla, CA
National Provider Identifier
1336709674
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
103765 Issued in CA
Practice address
4130 La Jolla Village Dr Ste 105
La Jolla, CA 92037-1480
Phone
(858) 455-7777
NPI assigned
Jun 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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 103765 CA Primary

Addresses

Primary practice location

4130 La Jolla Village Dr Ste 105
La Jolla, CA 92037-1480

Mailing address

8826 Pagoda Way
San Diego, CA 92126-3322
Phone (858) 218-5188

Other practice location 1

1530 Hilton Head Rd Ste 111
El Cajon, CA 92019-4655
Phone (619) 441-8000

Other practice location 2

2260 Otay Lakes Rd Ste 110
Chula Vista, CA 91915-1007
Phone (619) 482-5555

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

LicenseStateTypeSpecialty
103765CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel Hayatt DMD Inc. Past Accepting new patients
Faith Barreyro, DMD, Inc. PastSince Apr 19, 2020 Accepting new patients
Samuel Hayatt DMD, Inc. General Practice Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1336709674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8826 PAGODA WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921263322",
            "telephone_number": "858-218-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 LA JOLLA VILLAGE DR STE 105",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371480",
            "telephone_number": "858-455-7777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1530 Hilton Head Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920194655",
            "country_code": "US",
            "telephone_number": "619-441-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2260 Otay Lakes Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919151007",
            "country_code": "US",
            "telephone_number": "619-482-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARREYRO",
        "first_name": "FAITH-ROSELLE",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.