Healthcare Provider Details

I. General information

NPI: 1407003684
Provider Name (Legal Business Name): BEL AIR DENTAL HEALTH ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 05/16/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 ROCK SPRING RD STE 200
FOREST HILL MD
21050
US

IV. Provider business mailing address

1920 ROCK SPRING RD STE 200
FOREST HILL MD
21050
US

V. Phone/Fax

Practice location:
  • Phone: 410-879-4444
  • Fax: 410-893-1223
Mailing address:
  • Phone: 410-879-4444
  • Fax: 410-893-1223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JENNIFER A SCHALL
Title or Position: ADMINISTRATOR
Credential:
Phone: 410-879-4444