Provider Demographics
NPI:1487294195
Name:THE BAILEY DENTAL GROUP, PLLC
Entity type:Organization
Organization Name:THE BAILEY DENTAL GROUP, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMEKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-415-2100
Mailing Address - Street 1:473 LAURENCE DR
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75032-2092
Mailing Address - Country:US
Mailing Address - Phone:469-415-2100
Mailing Address - Fax:469-332-2814
Practice Address - Street 1:473 LAURENCE DR
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-2092
Practice Address - Country:US
Practice Address - Phone:469-415-2100
Practice Address - Fax:469-332-2814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1831418680OtherNPPES