Provider Demographics
NPI:1457435158
Name:BARLOW-DOONQUAH, SANDRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:BARLOW-DOONQUAH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 LAKEWALK DR
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-9608
Mailing Address - Country:US
Mailing Address - Phone:336-394-4191
Mailing Address - Fax:336-394-4191
Practice Address - Street 1:2509 RICHARDSON DR
Practice Address - Street 2:SUITE B
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-5900
Practice Address - Country:US
Practice Address - Phone:336-394-4191
Practice Address - Fax:336-394-4191
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC88041223D0001X
NC8284122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8284OtherDENTAL LICENSE
NC89902H6Medicaid