Healthcare Provider Details

I. General information

NPI: 1437087541
Provider Name (Legal Business Name): MICHELLE GAMIN LEE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N CHARLES ST
BALTIMORE MD
21201-5505
US

IV. Provider business mailing address

5928 SPRING LEAF CT
ELKRIDGE MD
21075-5994
US

V. Phone/Fax

Practice location:
  • Phone: 410-837-2050
  • Fax:
Mailing address:
  • Phone: 410-370-8903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: