Healthcare Provider Details

I. General information

NPI: 1407772437
Provider Name (Legal Business Name): DR. BRIDGET BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BREWSTER BLVD
CAMP LEJEUNE NC
28547-2538
US

IV. Provider business mailing address

1517 WINFIELD AVE
COLORADO SPRINGS CO
80906-3045
US

V. Phone/Fax

Practice location:
  • Phone: 910-451-1658
  • Fax:
Mailing address:
  • Phone: 217-521-3939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00206725
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: