Jun Tae Bae, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11589 Issued in MD

Practice address

13974 Baltimore Ave
Laurel, MD 20707-5086

Phone

(301) 490-8200

Fax

(301) 490-4300

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bae Dental Associates-Westminster LLC

  dba Family Dentistry of Westminster

  • General Practice Dentistry
  • Westminster, MD
  • NPI 1346695616
  NPD Authorized official
• Jun Tae Bae, DDS, PA

  dba Family Dentistry of Laurel

  • General Practice Dentistry
  • Laurel, MD
  • NPI 1588954366
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1013952068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13974 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075086",
            "telephone_number": "301-490-8200",
            "fax_number": "301-490-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13974 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075086",
            "telephone_number": "301-490-8200",
            "fax_number": "301-490-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAE",
        "first_name": "JUN",
        "middle_name": "TAE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael N Baako, MD
• Matilder Mbongho Babila
• Bac Health Services LLC
• Liliane Badawu
• Sade Bademosi
• Hannah Maiye Bafor
• Bagiwa Healthcare Services LLC (Bagiwa)
• Doreen Bagonza, RN BSN MPH CMSRN
• Ermalyn Baguio
• Amadou Bah

• General Practice Dentistry in Laurel, MD
• Providers in Laurel, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.