NPIMap

Organization Active NPI

Montefiore Dental Department

  • Dentist
  • Bronx, NY
National Provider Identifier
1801092341
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MONTEFIORE DENTAL DEPARTMENT
Practice address
1625 Poplar St
Bronx, NY 10461-2653
Phone
(888) 700-6623
Fax
(718) 515-5419
NPI assigned
Jun 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1625 Poplar St
Bronx, NY 10461-2653

Mailing address

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

Other names 1

  • MONTE PARK ORTHODONTICS Other name

National Provider Directory

National Provider Directory
Tax ID family
MMC at Icahn House Family Shelter520 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": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801092341",
    "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": "1625 POPLAR ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612653",
            "telephone_number": "888-700-6623",
            "fax_number": "718-515-5419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTEFIORE DENTAL DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2020-08-22",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MONTE PARK ORTHODONTICS",
            "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 Aug 22, 2020; 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.