Bailey Duffy, DMD
Individual provider Active NPI Pediatric Dentistry · Hanahan, SC
NPI 1558046995 · NPPES record last updated Dec 1, 2025
Key facts
- NPI
- 1558046995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 11206.PD (SC)
- Practice address
- 996 Tanner Ford Blvd
Hanahan, SC 29410-4780 - Phone
- (843) 818-5437
- NPI assigned
- Jun 21, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240104003712 | SC | Order and Referring Only - Dentist |
1557712486 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11206.PD | SC | MD | Pediatric Dentist |
| 10559 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dentistry for Children of South Carolina PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 11206.PD | SC | Yes |
Addresses
Primary practice location
996 Tanner Ford Blvd
Hanahan, SC 29410-4780
Mailing address
996 Tanner Ford Blvd
Hanahan, SC 29410-4780
Other providers in Hanahan, SC
- Joseph R Davis
- Susan Royal Davis
- Taylor Dempsey
- Dentistry for Children of South Carolina PC
- Isabel Ghowanlu Driggers
- Dana Durlach
- Amber Etienne
- Jennifer Teal Frazier
- Jessica Urania Frazier
- Brooke Jackson Gerlach
All providers in Hanahan, SC · Pediatric Dentistry in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2025. 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.