John Y. Barlow, D.D.S.

Individual provider Active NPI General Practice Dentistry · Hildale, UT

NPI 1619972569 · NPPES record last updated Oct 24, 2012

Key facts

NPI
1619972569
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
22607 (TX)
Practice address
1080 West Utah Ave
Hildale, UT 84784-1489
Phone
(435) 874-2555
Fax
(435) 874-2553
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
22607TXMDGeneral Practice Dentistry
278706-9922UTMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 278706-9922 UT
General Practice Dentistry 1223G0001X 22607 TX Yes

Addresses

Primary practice location

1080 West Utah Ave
Hildale, UT 84784-1489

Mailing address

1080 West Utah Ave
P.O. Box 841489
Hildale, UT 84784-1489
Phone (435) 874-2555

Other identifiers

IdentifierTypeStateIssuer
24-5710792OtherUTFEIN
197013OtherAZAHCCCS PROVIDER

Other providers in Hildale, UT

All providers in Hildale, UT · General Practice Dentistry in Utah

Sources for this page

Verify at the official NPI Registry.