Provider Demographics
NPI:1396913612
Name:BAILEY, JOHN H (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:BAILEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 W UNION HILLS DR
Mailing Address - Street 2:BUILDING 'B'
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-8189
Mailing Address - Country:US
Mailing Address - Phone:623-583-5969
Mailing Address - Fax:
Practice Address - Street 1:8801 W UNION HILLS DR
Practice Address - Street 2:BUILDING 'B'
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-8189
Practice Address - Country:US
Practice Address - Phone:623-583-5969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD1976122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist