Individual provider Active NPI

Erin Shari Bailey, DDS

  • Dentist
  • Portsmouth, VA
National Provider Identifier
1366788119
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15210 Issued in MD
Practice address
Naval Medical Center Portsmouth
620 John Paul Jones Circle
Portsmouth, VA 23708
Phone
(630) 300-4567
NPI assigned
Dec 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15210 MD
Dentist 122300000X 15210 MD Primary

Addresses

Primary practice location

Naval Medical Center Portsmouth
620 John Paul Jones Circle
Portsmouth, VA 23708

Mailing address

1632 Colchester LN
Aurora, IL 60505-9500
Phone (630) 300-4567

Other practice location 1

Naval Medical Center San Diego
Apo, AA 92134
Phone (619) 794-4599

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address erin.s.bailey4.mil@health.mil

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20210720000135 MD Order and Referring Only - DentistPractitioner - Dentist 9234532995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15210MDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1366788119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 COLCHESTER LN",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605059500",
            "telephone_number": "630-300-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER PORTSMOUTH",
            "address_2": "620 JOHN PAUL JONES CIRCLE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "23708",
            "telephone_number": "630-300-4567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Naval Medical Center San Diego",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AA",
            "postal_code": "92134",
            "country_code": "US",
            "telephone_number": "619-794-4599",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "ERIN",
        "middle_name": "SHARI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-26",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "15210",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "erin.s.bailey4.mil@health.mil",
            "affiliation": "N",
            "address_1": "Naval Medical Center Portsmouth",
            "address_2": "620 John Paul Jones Circle",
            "city": "Portsmouth",
            "state": "VA",
            "country_code": "US",
            "postal_code": "23708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.