Hyun M. Bae, DDS
Individual provider Active NPI Dentist · Cambridge, MD
NPI 1982956991 · NPPES record last updated Apr 28, 2016
Key facts
- NPI
- 1982956991
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 15266 (MD)
- Practice address
- 406 Lecompte St
Cambridge, MD 21613-2437 - Phone
- (410) 228-8770
- Fax
- (410) 228-0598
- NPI assigned
- Oct 15, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160511001337 | MD | Order and Referring Only - Other (Physician) |
9436448644 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hyun M. Bae DDS | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15266 | MD | Yes |
Addresses
Primary practice location
406 Lecompte St
Cambridge, MD 21613-2437
Mailing address
406 Lecompte St
Cambridge, MD 21613-2437
Phone (410) 228-8770
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046728400 | Medicaid | DC | |
| 072707500 | Medicaid | MD |
Other providers in Cambridge, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.