NPIMap

Organization Active NPI

Clinton High School

  • Dentist
  • Bronx, NY
National Provider Identifier
1710161161
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CLINTON HIGH SCHOOL
Practice address
100 W Mosholu Pkwy S
Bronx, NY 10468-1001
Phone
(718) 696-4071
NPI assigned
Dec 20, 2007
Last updated
Dec 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

100 W Mosholu Pkwy S
Bronx, NY 10468-1001

Mailing address

PO Box 4156
Church Street Station
New York, NY 10261-4156
Phone (718) 920-4649

Other names 1

  • School Health Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Robert D Zimmerman520 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

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1710161161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4156",
            "address_2": "CHURCH STREET STATION",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102614156",
            "telephone_number": "718-920-4649",
            "fax_number": "718-515-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W MOSHOLU PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104681001",
            "telephone_number": "718-696-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON HIGH SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "BROCKET",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "School Health Program",
            "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 Dec 20, 2007; 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.