Individual provider Active NPI

Bernabe Barr Urbano Ambrosio, DMD

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1952454019
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50720 Issued in CA
Practice address
12120 Alta Carmel CT
Suite 410C
San Diego, CA 92128-3864
Phone
(858) 385-9188
Fax
(858) 385-9328
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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 50720 CA Primary

Addresses

Primary practice location

12120 Alta Carmel CT
Suite 410C
San Diego, CA 92128-3864

Mailing address

12120 Alta Carmel CT
Suite 410C
San Diego, CA 92128-3864
Phone (858) 385-9188

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
I20160226000464 CA Order and Referring Only - DentistPractitioner - Dentist 6800191024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50720CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Care of Rancho Bernardo Current Accepting new patients

Locations

12120 Alta Carmel Ct
Ste 410C
San Diego, CA 92128
Phone (858) 385-9188

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1952454019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12120 ALTA CARMEL CT",
            "address_2": "SUITE 410C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283864",
            "telephone_number": "858-385-9188",
            "fax_number": "858-385-9328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12120 ALTA CARMEL CT",
            "address_2": "SUITE 410C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283864",
            "telephone_number": "858-385-9188",
            "fax_number": "858-385-9328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSIO",
        "first_name": "BERNABE BARR",
        "middle_name": "URBANO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.