Provider Demographics
NPI:1710057435
Name:JEFF BARLOW DDS AND MAYNA CHAU DDS
Entity Type:Organization
Organization Name:JEFF BARLOW DDS AND MAYNA CHAU DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-241-6460
Mailing Address - Street 1:12240 HESPERIA RD # C
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-7700
Mailing Address - Country:US
Mailing Address - Phone:760-241-6460
Mailing Address - Fax:760-241-2006
Practice Address - Street 1:12240 HESPERIA RD # C
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-7700
Practice Address - Country:US
Practice Address - Phone:760-241-6460
Practice Address - Fax:760-241-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA360591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty