Michael R Bailey MD DDS PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D3165/M6325 Issued in ID

Legal business name

MICHAEL R BAILEY MD DDS PA

Practice address

403 S 11TH St
Suite 300
Boise, ID 83702-6968

Phone

(208) 344-9115

Fax

(208) 344-9113

NPI assigned

Apr 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael R Bailey, MD DDS

Title

Owner

Phone

(208) 344-9115

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1053584284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 S 11TH ST",
            "address_2": "SUITE 300",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026968",
            "telephone_number": "208-344-9115",
            "fax_number": "208-344-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 S 11TH ST",
            "address_2": "SUITE 300",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026968",
            "telephone_number": "208-344-9115",
            "fax_number": "208-344-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL R BAILEY MD DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-344-9115",
        "authorized_official_credential": "MD DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ID",
            "license": "D3165/M6325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michael V Hajjar MD
• Erin Michaelis, NP
• Mark Michaud, MD

• Oral and Maxillofacial Surgery (Dentist) in Boise, ID
• Providers in Boise, ID by specialty
• Oral and Maxillofacial Surgery (Dentist) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.