IndividualActive
Jonathan Bacon, D.D.S.
NPI 1811336142 · Dental Anesthesiology · Baltimore, MD
Provider details
- NPI number
- 1811336142
- Entity type
- Individual
- Primary specialty
- Dental AnesthesiologyDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 15309 (MD)
Specialties & taxonomies
Dental Providers
Dental Providers
Practice location
2700 Quarry Lake Dr Ste 190
Baltimore, MD 21209-3743
Phone: (410) 484-4401
Approximate (ZIP-level) locationGet directions
Mailing address
1220 Caraway Ct Ste 1050
Upper Marlboro, MD 20774-5338
Registry dates
- Enumerated
- 2013-06-20
- Last updated
- 2019-10-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.