DR. HECTOR BOLIVAR BERNABE DDS NPI 1104815406

NPI Information

NPI: 1104815406
Provider Name: DR. HECTOR BOLIVAR BERNABE, DDS
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Individual
PECOS Registration: Yes
Address: 1916 GRAND CONCOURSE
BRONX, NY
ZIP 10457
Phone: (718) 716-1400

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NPI Details

DR. Hector Bolivar Bernabe, DDS is a general practice dentist in Bronx, NY. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Hector Bolivar Bernabe, DDS NPI is 1104815406. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1916 GRAND CONCOURSE
BRONX, NY
ZIP 10457-201
Phone: (718) 716-1400
Fax: (718) 716-7025

The NPI 1104815406 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 10/19/2005 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	043696	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01277687	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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