Provider Demographics
NPI:1003804279
Name:BARBER, HARGROW DEXTER (DDS)
Entity Type:Individual
Prefix:
First Name:HARGROW
Middle Name:DEXTER
Last Name:BARBER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 S RURAL RD
Mailing Address - Street 2:SOUTHWEST DENTAL GROUP
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3747
Mailing Address - Country:US
Mailing Address - Phone:480-456-0821
Mailing Address - Fax:
Practice Address - Street 1:100 E LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-1000
Practice Address - Country:US
Practice Address - Phone:215-707-3613
Practice Address - Fax:215-707-5405
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027665L1223S0112X
NJ22DI0200611223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5530504Medicaid
PAT96937Medicare UPIN
NJ087416NKYMedicare PIN
NJ087416ANOMedicare PIN