NPIMap

Organization Active NPI

Montefiore Dental

  • Dentist
  • Bronx, NY
National Provider Identifier
1194920496
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MONTEFIORE DENTAL
Practice address
1575 Blondell Ave
First Floor
Bronx, NY 10461-2660
Phone
(888) 700-6623
Fax
(718) 515-5419
NPI assigned
Jun 18, 2007
Last updated
Nov 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Authorized official

Name
Charles Brockett
Title
Administrator
Phone
(718) 920-4167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

1575 Blondell Ave
First Floor
Bronx, NY 10461-2660

Mailing address

PO Box 4156
New York, NY 10261-4156
Phone (718) 920-4168

Other names 1

  • BLONDELL DENTAL DEPARTMENT Other name

National Provider Directory

National Provider Directory
Tax ID family
MMC Rehab Medicine520 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1575 Blondell Ave
Fl First
Bronx, NY 10461

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1194920496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4156",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102614156",
            "telephone_number": "718-920-4168",
            "fax_number": "718-515-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 BLONDELL AVE",
            "address_2": "FIRST FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612660",
            "telephone_number": "888-700-6623",
            "fax_number": "718-515-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTEFIORE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "BROCKETT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-920-4167"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLONDELL DENTAL DEPARTMENT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.