Individual provider · NPI-1

Dr. Kaderus Bailey, DDS

Dentist · Lake Charles, LA

NPI number1780433995
StatusActive
Last updated in NPPESJul 31, 2025

Details

NPI
1780433995
Entity type
Individual (NPI-1)
Name
Dr. Kaderus Bailey
Credential
DDS
Sex
Male
Sole proprietor
Yes
Enumeration date
May 20, 2024
Certification date
Jul 16, 2025
Last updated
Jul 31, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist7608LAYes

Practice location

2000 Opelousas St
Lake Charles, LA 70601-2641

Phone 337-439-9983

Mailing address

3500 Manchester Dr
Charlotte, NC 28217-1142

Phone 704-390-0868

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