Healthcare Provider Details

I. General information

NPI: 1558829192
Provider Name (Legal Business Name): JORDAN BARBER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2019
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8267 LITTLE RD
NEW PORT RICHEY FL
34654-5407
US

IV. Provider business mailing address

849 CALLISTA CAY LOOP
TARPON SPRINGS FL
34689-0002
US

V. Phone/Fax

Practice location:
  • Phone: 727-807-9117
  • Fax: 727-807-9146
Mailing address:
  • Phone: 412-580-4553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN28540
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: