Provider Demographics
NPI:1366610651
Name:BAILEYS, STEVEN JEFFERY (DDS)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JEFFERY
Last Name:BAILEYS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N JOHNSON AVE
Mailing Address - Street 2:SUITE P
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-2592
Mailing Address - Country:US
Mailing Address - Phone:619-444-3127
Mailing Address - Fax:619-444-3138
Practice Address - Street 1:700 N JOHNSON AVE
Practice Address - Street 2:SUITE P
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-2592
Practice Address - Country:US
Practice Address - Phone:619-444-3127
Practice Address - Fax:619-444-3138
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31198122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist