Individual provider Active NPI

Alyson Terry Barnes, DDS

  • Endodontics
  • Aloha, OR
National Provider Identifier
1679730790
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D9829 Issued in OR
Practice address
18395 SW Alexander St
Aloha, OR 97003-3961
Phone
(503) 642-4552
Fax
(503) 591-0202
NPI assigned
May 16, 2008
Last updated
May 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DE60632860 WA
Endodontics 1223E0200X D9829 OR Primary
General Practice Dentistry 1223G0001X DN18563 FL
General Practice Dentistry 1223G0001X DN 1855133 MA
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

18395 SW Alexander St
Aloha, OR 97003-3961

Mailing address

18395 SW Alexander St
Aloha, OR 97003-3961
Phone (503) 642-4552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20150922003077 OR Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7113234204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D9829ORMDEndodontist
DE60632860WAMDEndodontist
DN18563FLMDGeneral Practice Dentistry
DN 1855133MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pearl Endodontics, PC Endodontics CurrentSince May 24, 2020 Accepting new patients
Northwest Endodontics, PC Endodontics PastSince May 24, 2020 Accepting new patients

Locations

18395 SW Alexander St
Aloha, OR 97003
Phone (503) 642-4552

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1679730790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18395 SW ALEXANDER ST",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970033961",
            "telephone_number": "503-642-4552",
            "fax_number": "503-591-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18395 SW ALEXANDER ST",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970033961",
            "telephone_number": "503-642-4552",
            "fax_number": "503-591-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "ALYSON",
        "middle_name": "TERRY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE60632860",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D9829",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18563",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN 1855133",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aloha, OR

Sources for this page

Verify at the official NPI Registry.