Provider Demographics
NPI:1407957723
Name:BAILEY, JAMES IVAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:IVAN
Last Name:BAILEY
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 1:230 N CEDAR HILLS DR
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-2746
Mailing Address - Country:US
Mailing Address - Phone:435-637-3186
Mailing Address - Fax:435-637-3838
Practice Address - Street 1:230 N CEDAR HILLS DR
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-2746
Practice Address - Country:US
Practice Address - Phone:435-637-3186
Practice Address - Fax:435-637-3838
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT135569-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice