Healthcare Provider Details

I. General information

NPI: 1851224455
Provider Name (Legal Business Name): CONNOR LU DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

9256 BENDIX RD STE 202
COLUMBIA MD
21045-1848
US

IV. Provider business mailing address

9256 BENDIX RD STE 202
COLUMBIA MD
21045-1848
US

V. Phone/Fax

Practice location:
  • Phone: 410-461-6655
  • Fax:
Mailing address:
  • Phone: 410-461-6655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18700
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: