Brian Edwin Bailey, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.027383 Issued in IL

Practice address

13011 S 104TH Ave
Suite # 209
Palos Park, IL 60464-1506

Phone

(708) 974-0278

NPI assigned

Nov 16, 2010

Last updated

Feb 7, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423267200000",
    "number": "1083915474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13011 S 104TH AVE",
            "address_2": "SUITE # 209",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641506",
            "telephone_number": "708-974-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13011 S 104TH AVE",
            "address_2": "SUITE # 209",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641506",
            "telephone_number": "708-974-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "BRIAN",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-16",
        "last_updated": "2015-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.027383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John J Arrotti, M.D.
• Rajitha Lakshmi Avva, MD
• Zainah Azar, PA-C
• B M Khan DO PC
• Linda G Baer, PSYD
• Jonathan L. Belgrad, M.D.
• Mallory Marie Berg, FNP-C
• Roy C Bliley, M.D.
• Bridget Ann Boam
• Noor Bsul, PHARMD

• General Practice Dentistry in Palos Park, IL
• Providers in Palos Park, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.