Individual provider Active NPI

Stephen Baral, D.M.D.

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1720258460
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20498 Issued in CA
Practice address
5189 Clairemont Mesa Blvd
San Diego, CA 92117-1446
Phone
(858) 414-3460
NPI assigned
Mar 10, 2008
Last updated
Dec 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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 20498 CA Primary

Addresses

Primary practice location

5189 Clairemont Mesa Blvd
San Diego, CA 92117-1446

Mailing address

6154 Soledad Mountain Rd
La Jolla, CA 92037-7016
Phone (858) 414-3460

Other practice location 1

306 Walnut Ave Ste 36
San Diego, CA 92103-4936
Phone (619) 298-2942

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective May 23, 2016 through May 23, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Enbara Corporation General Practice CurrentSince Dec 16, 2020 Accepting new patients

Locations

5189 Clairemont Mesa Blvd
San Diego, CA 92117
Phone (619) 734-2886

Organizations & group practices 1

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": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1720258460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6154 SOLEDAD MOUNTAIN RD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920377016",
            "telephone_number": "858-414-3460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5189 CLAIREMONT MESA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921171446",
            "telephone_number": "858-414-3460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 Walnut Ave Ste 36",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921034936",
            "country_code": "US",
            "telephone_number": "619-298-2942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARAL",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-10",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "20498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.