Provider Demographics
NPI:1548006984
Name:BAILEY, ERIKA ANN (DMD)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:ANN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 AUDACE AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3321
Mailing Address - Country:US
Mailing Address - Phone:302-668-7276
Mailing Address - Fax:
Practice Address - Street 1:1321 NW SAINT LUCIE WEST BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2139
Practice Address - Country:US
Practice Address - Phone:772-343-0179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29317122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist