BRONXCARE DENTAL SERVICES – NPI #1619275039
Clinic/Center

BRONXCARE DENTAL SERVICES is an AHC clinic located in BRONX, NY. NPPES has assigned the NPI number 1619275039 to BRONXCARE DENTAL SERVICES on March 09, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “BRONXCARE DENTAL SERVICES” is a dba name, the actual legal business name for this organization is BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 8 years ago on Jun 28, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BRONXCARE DENTAL SERVICES below.

NPI Profile for
BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER

NPI Number
1619275039
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BRONXCARE DR. MARTIN LUTHER KING JR. HEALTH CENTER
Doing Business As (dba): BRONXCARE DENTAL SERVICES
Primary location
1775 GRAND CONCOURSE
BRONX, NY 10453
Phone: (718) 901-8600 Fax: (718) 293-1475
Mailing address
1276 FULTON AVE
BRONX, NY 10456-3402
Phone: (718) 901-8600 Fax: (718) 293-1475
Organization Subpart
Yes - BRONXCARE DENTAL SERVICES is subpart of another organization.
Authorized Official
VICTOR DEMARCO
SENIOR VP-CHIEF FINANCIAL OFFICER
Phone: (718) 901-8600
Updated
Identifiers

Identifiers for BRONXCARE DENTAL SERVICES

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERBLUE CROSSNYW0437
MEDICAIDNY03410919
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
NY 7000212R

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.