Healthcare Provider Details

I. General information

NPI: 1174490726
Provider Name (Legal Business Name): JOSHUA ALLEN DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4765 CARMEL MOUNTAIN RD STE 210
SAN DIEGO CA
92130-6657
US

IV. Provider business mailing address

4765 CARMEL MOUNTAIN RD STE 210
SAN DIEGO CA
92130-6657
US

V. Phone/Fax

Practice location:
  • Phone: 858-755-9511
  • Fax: 858-755-8511
Mailing address:
  • Phone: 858-755-9511
  • Fax: 858-755-8511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSHUA ALLEN
Title or Position: OWNER
Credential: DDS
Phone: 858-755-9511