MEDICARE: BALTIMORE ENDODONTIC ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1023953908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALTIMORE ENDODONTIC ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	8 SAGEWOOD CT
Second Line	:
City	:	SPARKS GLENCOE
State	:	MD
Zip	:	21152-9304
Country	:	US
Telephone Number	:	443-794-4108
Fax Number	:

Provider Business Practice Location Address
First Line	:	8601 LASALLE RD
Second Line	:	STE 203
City	:	TOWSON
State	:	MD
Zip	:	21286-2004
Country	:	US
Telephone Number	:	443-794-4108
Fax Number	:

Authorized Official
Title or Position	:	ENDODONTIST
Name	:	DR. HEEJUN K LEE
Credential	:	DDS
Telephone Number	:	443-794-4108

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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