Individual provider Active NPI

Allen R Ehlers, DDS

  • General Practice Dentistry
  • McKinleyville, CA
National Provider Identifier
1710964762
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23601 Issued in CA
Practice address
1585 Heartwood Dr
Suite B
McKinleyville, CA 95519-3991
Phone
(707) 839-3284
Fax
(707) 839-2910
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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 23601 CA Primary

Addresses

Primary practice location

1585 Heartwood Dr
Suite B
McKinleyville, CA 95519-3991

Mailing address

1585 Heartwood Dr
Suite B
McKinleyville, CA 95519-3991
Phone (707) 839-3284

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

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1710964762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 HEARTWOOD DR",
            "address_2": "SUITE B",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955193991",
            "telephone_number": "707-839-3284",
            "fax_number": "707-839-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 HEARTWOOD DR",
            "address_2": "SUITE B",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955193991",
            "telephone_number": "707-839-3284",
            "fax_number": "707-839-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHLERS",
        "first_name": "ALLEN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "23601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinleyville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.