Healthcare Provider Details

I. General information

NPI: 1679093603
Provider Name (Legal Business Name): COLIN JOHN STANHOPE DDS, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 W BALTIMORE ST
BALTIMORE MD
21201-1510
US

IV. Provider business mailing address

1511 S CHARLES ST
BALTIMORE MD
21230-4414
US

V. Phone/Fax

Practice location:
  • Phone: 410-706-7101
  • Fax:
Mailing address:
  • Phone: 240-286-9732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD0096480
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number16449
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: