Provider Demographics
NPI:1609017466
Name:BAILEY, JOHN RODNEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RODNEY
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 1:600 W ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20059-0001
Mailing Address - Country:US
Mailing Address - Phone:202-806-0064
Mailing Address - Fax:202-806-0477
Practice Address - Street 1:600 W ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20059-0001
Practice Address - Country:US
Practice Address - Phone:202-806-0064
Practice Address - Fax:202-806-0477
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN50341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice