Healthcare Provider Details

I. General information

NPI: 1265351902
Provider Name (Legal Business Name): BAILEY PETERSEN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3731 NW CARY PKWY STE 201
CARY NC
27513-8436
US

IV. Provider business mailing address

3731 NW CARY PKWY STE 201
CARY NC
27513-8436
US

V. Phone/Fax

Practice location:
  • Phone: 919-460-9665
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14825
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: