Healthcare Provider Details

I. General information

NPI: 1619541497
Provider Name (Legal Business Name): ALANDRAH NICHOLE BAILEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 HINKLE ST SE
ALBUQUERQUE NM
87102-4930
US

IV. Provider business mailing address

2116 HINKLE ST SE
ALBUQUERQUE NM
87102-4930
US

V. Phone/Fax

Practice location:
  • Phone: 505-843-7493
  • Fax: 505-214-5029
Mailing address:
  • Phone: 505-843-7493
  • Fax: 505-214-5029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDD5463
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: