Healthcare Provider Details

I. General information

NPI: 1699660514
Provider Name (Legal Business Name): BAILEY HUBBARD DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14662 N US HIGHWAY 25 E
CORBIN KY
40701-6425
US

IV. Provider business mailing address

1019 CUMBERLAND FALLS HWY STE B201
CORBIN KY
40701-2793
US

V. Phone/Fax

Practice location:
  • Phone: 606-526-9005
  • Fax: 606-526-8607
Mailing address:
  • Phone: 606-526-9005
  • Fax: 606-528-3871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11347
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: