Provider Demographics
NPI:1073964284
Name:BARR, TRAVIS JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:JAY
Last Name:BARR
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 1:7889 S LINCOLN CT STE 202
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2638
Mailing Address - Country:US
Mailing Address - Phone:303-798-4967
Mailing Address - Fax:
Practice Address - Street 1:3333 S WADSWORTH BLVD UNIT D305
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5142
Practice Address - Country:US
Practice Address - Phone:303-985-1615
Practice Address - Fax:303-985-1617
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00202886122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODEN.00202886OtherLICENSE NUMBER