Individual provider · Type 1 NPI

Jairo Bastidas, DMD

Oral and Maxillofacial Surgery (Dentist) · Bronx, NY

NPI number 1780763300 Active

Practice location

111 E 210th St
Bronx, NY 10467-2401

Call (718) 920-4167 Map

Fax (718) 515-5419

Mailing address

90 Palisade Ave
White Plains, NY 10607-2725

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X041328 (NY)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1780763300

Jairo Bastidas, DMD's National Provider Identifier is 1780763300, issued on Nov 3, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Bronx, NY. The record was last updated on Jul 8, 2007.