Basic Information
| Provider Information | |||||||||
| NPI: | 1063508737 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAILEY | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10514 ROYAL OAK RD | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946055038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5106328396 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1851 SUTTER ST | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945202520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9258272798 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 12/29/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223X0400X | 21689 | CA | Y | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics |
No ID Information.