James Robert Bailey, D.D.S.

Individual provider Active NPI General Practice Dentistry · Indianapolis, IN

NPI 1265633101 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1265633101
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
12010042 (IN)
Practice address
2291 N Meridian St
Indianapolis, IN 46208-5727
Phone
(317) 926-5467
Fax
(317) 926-6022
NPI assigned
May 29, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20161215001387 IN Order and Referring Only - Dentist
Practitioner - Dentist
5193005874

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
12010042INMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12010042 IN Yes

Addresses

Primary practice location

2291 N Meridian St
Indianapolis, IN 46208-5727

Mailing address

2291 N Meridian St
Indianapolis, IN 46208-5727
Phone (317) 926-5467

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · General Practice Dentistry in Indiana

Sources for this page

Verify at the official NPI Registry.