MEDICARE: JEFFREY C. BAILEY, DDS, MS, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	0401007646	VA

General Provider Information

NPI Number	:	1821148511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY C. BAILEY, DDS, MS, P.C.

Provider Business Mailing Address
First Line	:	1432 N GREAT NECK RD STE 102
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-1342
Country	:	US
Telephone Number	:	757-486-7857
Fax Number	:	757-486-4441

Provider Business Practice Location Address
First Line	:	1432 N GREAT NECK RD STE 102
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-1342
Country	:	US
Telephone Number	:	757-486-7857
Fax Number	:	757-486-4441

Authorized Official
Title or Position	:	OWNER, PRESIDENT
Name	:	JEFFREY BAILEY
Credential	:	DDS
Telephone Number	:	757-486-7857

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	08/22/2020

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