MEDICARE: LAUREN JESSICA BARLOW DDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	112340	CA

General Provider Information

NPI Number	:	1750248241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN JESSICA BARLOW DDS, MS

Provider Business Mailing Address
First Line	:	623 NOTTINGHAM DR
Second Line	:
City	:	REDLANDS
State	:	CA
Zip	:	92373-5766
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1643 S SAN JACINTO AVE
Second Line	:
City	:	SAN JACINTO
State	:	CA
Zip	:	92583-5181
Country	:	US
Telephone Number	:	951-654-7744
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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