Provider Demographics
NPI:1184772733
Name:BAILEY, JEFFREY C (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:C
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 1:1432 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:
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:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010076461223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics