Provider Demographics
NPI:1821148511
Name:JEFFREY C. BAILEY, DDS, MS, P.C.
Entity Type:Organization
Organization Name:JEFFREY C. BAILEY, DDS, MS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-486-7857
Mailing Address - Street 1:1432 N GREAT NECK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-1342
Mailing Address - Country:US
Mailing Address - Phone:757-486-7857
Mailing Address - Fax:757-486-4441
Practice Address - Street 1:1432 N GREAT NECK RD STE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-1342
Practice Address - Country:US
Practice Address - Phone:757-486-7857
Practice Address - Fax:757-486-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010076461223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty