Provider Demographics
NPI:1720300585
Name:MODLIN, SARAH BARROW (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:BARROW
Last Name:MODLIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BARROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1642 CLARKSON RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-4601
Mailing Address - Country:US
Mailing Address - Phone:636-728-1540
Mailing Address - Fax:
Practice Address - Street 1:1642 CLARKSON RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4601
Practice Address - Country:US
Practice Address - Phone:636-728-1540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0281171223G0001X
MO20200283401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice