Provider Demographics
NPI:1205723384
Name:BLUM, LAUREN BROOKE (DDS)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:BROOKE
Last Name:BLUM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MAEVE CT
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1422
Mailing Address - Country:US
Mailing Address - Phone:443-992-9436
Mailing Address - Fax:
Practice Address - Street 1:9650 BELAIR RD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-1106
Practice Address - Country:US
Practice Address - Phone:410-256-2044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD184891223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics