Fred E Bailey
Individual provider Active NPI Dentist · Kansas City, MO
NPI 1003989948 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003989948
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 013597 (MO)
- Practice address
- 5420 NE Antioch Road
Kansas City, MO 64119 - Phone
- (816) 452-9700
- Fax
- (816) 452-9779
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013597 | MO | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 013597 | MO | Yes |
Addresses
Primary practice location
5420 NE Antioch Road
Kansas City, MO 64119
Mailing address
5420 NE Antioch Road
Kansas City, MO 64119
Phone (816) 452-9700
Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.