Provider Demographics
NPI:1619972569
Name:BARLOW, JOHN Y (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:Y
Last Name:BARLOW
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 1:1080 WEST UTAH AVE
Mailing Address - Street 2:P.O. BOX 841489
Mailing Address - City:HILDALE
Mailing Address - State:UT
Mailing Address - Zip Code:84784-1489
Mailing Address - Country:US
Mailing Address - Phone:435-874-2555
Mailing Address - Fax:435-874-2553
Practice Address - Street 1:1080 WEST UTAH AVE
Practice Address - Street 2:
Practice Address - City:HILDALE
Practice Address - State:UT
Practice Address - Zip Code:84784-1489
Practice Address - Country:US
Practice Address - Phone:435-874-2555
Practice Address - Fax:435-874-2553
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT278706-99221223G0001X
TX226071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT24-5710792OtherFEIN
AZ197013OtherAHCCCS PROVIDER