Healthcare Provider Details

I. General information

NPI: 1083309967
Provider Name (Legal Business Name): CARRINGTON BAILEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 11/25/2024
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 PROVIDENCE ROAD
CHARLOTTE NC
28207
US

IV. Provider business mailing address

201 PROVIDENCE ROAD
CHARLOTTE NC
28207
US

V. Phone/Fax

Practice location:
  • Phone: 704-496-2966
  • Fax: 704-496-2966
Mailing address:
  • Phone: 704-496-2966
  • Fax: 704-496-2966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number13597
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: