Healthcare Provider Details

I. General information

NPI: 1215636592
Provider Name (Legal Business Name): BENJAMIN BAUM DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 WASHINGTON HEIGHTS MED CTR
WESTMINSTER MD
21157-5633
US

IV. Provider business mailing address

2412 SYLVALE RD
BALTIMORE MD
21209-1539
US

V. Phone/Fax

Practice location:
  • Phone: 410-848-5700
  • Fax:
Mailing address:
  • Phone: 917-526-0077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number17989
License Number StateMD
# 2
Primary TaxonomyN
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: