Individual provider Active NPI

Prince N. Morgan, DMD

  • General Practice Dentistry
  • Bronx, NY
National Provider Identifier
1770746786
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
057210 Issued in NY
Practice address
1775 Grand Concourse
Bronx, NY 10453
Phone
(718) 992-7669
NPI assigned
Jul 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 057210 NY Primary

Addresses

Primary practice location

1775 Grand Concourse
Bronx, NY 10453

Mailing address

1775 Grand Concourse
Bronx, NY 10453-8202
Phone (718) 992-7669

Other identifiers 1

IdentifierTypeStateIssuer
010311OtherCTCT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180723002245 NY Practitioner - Dentist 6204183221 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
057210NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Jul 1, 2018 Accepting new patients
Bronxcare Health System CurrentSince Jul 1, 2018 Accepting new patients
Union Community Health Center, Inc. CurrentSince Jun 1, 2025 Accepting new patients

Locations

2016 Bronxdale Ave
Bronx, NY 10462
Phone (718) 822-1515

1775 Grand Concourse
Bronx, NY 10453
Phone (718) 901-8400

2021 Grand Concourse
Bronx, NY 10453
Phone (718) 299-2800

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

2016 Bronxdale Ave
Ste 303
Bronx, NY 10462
Phone (718) 792-7972

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1770746786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104538202",
            "telephone_number": "718-992-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10453",
            "telephone_number": "718-992-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "PRINCE",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENSE",
            "identifier": "010311",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.