Provider Demographics
NPI:1912429358
Name:BAILEY, SARA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
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 1:2109 CUMING ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-4325
Mailing Address - Country:US
Mailing Address - Phone:402-280-5034
Mailing Address - Fax:
Practice Address - Street 1:2109 CUMING ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-4325
Practice Address - Country:US
Practice Address - Phone:307-251-0915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY14721223G0001X
AL0006794-C11223G0001X
NE7878122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice