Provider Demographics
NPI:1922198928
Name:BAILEY, DANIEL LIONEL JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LIONEL
Last Name:BAILEY
Suffix:JR
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 1:19916 NW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2904
Mailing Address - Country:US
Mailing Address - Phone:305-652-3131
Mailing Address - Fax:305-652-1215
Practice Address - Street 1:19916 NW 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-2904
Practice Address - Country:US
Practice Address - Phone:305-652-3131
Practice Address - Fax:305-652-1215
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0013666122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist