Provider Demographics
NPI:1629097241
Name:BAILEY, JEANNE KAYE (DDS)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:KAYE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9237
Mailing Address - Country:US
Mailing Address - Phone:304-757-7428
Mailing Address - Fax:304-757-3535
Practice Address - Street 1:1401 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9237
Practice Address - Country:US
Practice Address - Phone:304-757-7428
Practice Address - Fax:304-757-3535
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV26821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice