Provider Demographics
NPI:1154915494
Name:HOLLIHAN, BAILEY (DDS)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:HOLLIHAN
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 W MOREHEAD ST
Mailing Address - Street 2:STE 500 UNIT 412
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-5581
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1213 W MOREHEAD ST
Practice Address - Street 2:STE 500 UNIT 412
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5581
Practice Address - Country:US
Practice Address - Phone:704-837-7787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0450291223D0004X
NC136091223D0004X
SC106001223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology