DR. CHARLES HENRY BLOOM (NPI# 1174731954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174731954 |
| Entity Type | Individual |
| Full Name | DR. CHARLES HENRY BLOOM |
| Credential | D.M.D. |
| Practice Address |
815 Livingston Ave New Brunswick NJ 08901-3344 |
| Practice Telephone | 7322496386 |
| Practice Fax Number | 7322496283 |
| Mailing Telephone | 7322496386 |
| Mailing Fax Number | 7322496283 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
22DI01554800 | NJ | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285773457 | Charles Stephen Bloom | Obstetrics & Gynecology | 1371 Harmon Ave, Winter Park, FL 32789-5512 | 2007-02-05 |
| 1750588208 | Charles Warren Bloom | Recreation Therapist | 15900 S Cicero Ave, Oak Forest, IL 60452-4006 | 2007-06-28 |
| 1548202526 | Charles Bloom | Emergency Medicine | 1800 W Charleston Blvd, University Medical Center, Las Vegas, NV 89102-2329 | 2006-06-12 |
| Street Address |
815 LIVINGSTON AVE |
| City | NEW BRUNSWICK |
| State | NJ |
| Zip Code | 08901-3344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487862967 | Gari Goldberg Bloom | Dentist | 815 Livingston Ave, New Brunswick, NJ 08901-3344 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083242622 | Daniel Kareem Haddad | Student in an Organized Health Care Education/Training Program | 1 Robert Wood Johnson Place, Meb 422a, New Brunswick, NJ 08901 | 2020-03-30 |
| 1922636588 | Neil Anjan Basumallik | Student in an Organized Health Care Education/Training Program | Rutgers Rwjms, Department of Medicine, 125 Paterson Street. Cab 7300, New Brunswick, NJ 08901 | 2020-03-30 |
| 1922636406 | Naveena Lall | Student in an Organized Health Care Education/Training Program | Rutgers Robert Wood Johnson Internal Medicine Residency, 125 Paterson Street, New Brunswick, NJ 08901 | 2020-03-30 |
| 1801444047 | Swati Vijay Dhobale | Student in an Organized Health Care Education/Training Program | Saint Peter's University Hospital, 254 Easton Avenue, 4th Floor, Cares Room 4014, New Brunswick, NJ 08901 | 2019-08-30 |
| 1962974329 | Lauren Burgstresser | Nurse Practitioner | 181 Somerset Street, 3rd Floor, New Brunswick, NJ 08901 | 2018-12-26 |
| 1851874291 | Damon House Inc. | Substance Abuse Rehabilitation Facility | 105 Joyce Kilmer Ave, New Brunswick, NJ 08901 | 2018-09-12 |
| 1245718204 | Leah Dinardo | Psychologist | 61 Nichol Ave, New Brunswick, NJ 08901 | 2018-08-01 |
| 1730667130 | Keshav Bhandari | Student in an Organized Health Care Education/Training Program | Saint Peters University Hospital, 254 Easton Avenue, 4th Floor Cares, Rm 4014, New Brunswick, NJ 08901 | 2018-07-30 |
| 1942787486 | Mehak Bassi | Student in an Organized Health Care Education/Training Program | 4th Floor Cares, Rm 4014 240 Easton Avenue, New Brunswick, NJ 08901 | 2018-07-27 |
| 1063908754 | Oluwatoba Opeyemi Moninuola | Student in an Organized Health Care Education/Training Program | 4th Floor Cares, Rm 4014, 240 Easton Avenue, New Brunswick, NJ 08901 | 2018-07-05 |
| Find all providers in zip 08901 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124403795 | Heba Elkassaby | Dentist | 110 Bergen St Rm C-703, Newark, NJ 07103-2495 | 2015-07-24 |
| 1396131371 | Nakul H Rathi | Dentist | 28 Powderhorn Dr, Rockaway, NJ 07866-4835 | 2015-04-07 |
| 1447507785 | Smile Design Specialist, L.L.C. | Dentist | 312 Belleville Turnpike, Suite 3-b, North Arlington, NJ 07031-6460 | 2012-08-06 |
| 1619234358 | Sherman Farahani | Dentist | 1100 Maxwell Ln Unit 1106, Hoboken, NJ 07030-6881 | 2012-04-19 |
| 1144595356 | Advanced Dental of Woolwich | Dentist | 1630 Rt 322, Suite F, Woolwich, NJ 08085 | 2012-03-21 |
| 1164792453 | Daniel Seth Greenbaum | Dentist | 592 Us Highway 46, Fairfield, NJ 07004 | 2012-01-04 |
| 1013161553 | George Thomas Favetta Jr. | Dentist | 1966 Washington Valley Rd, Martinsville, NJ 08836-2037 | 2008-11-11 |
| 1740432137 | Central New Jersey Prosthodontics LLC | Dentist | 115 Copperfield Ln, Metuchen, NJ 08840-1234 | 2008-10-16 |
| 1043478977 | Edward J Kuch | Dentist | 733 River Road, Fair Haven, NJ 07704-3311 | 2008-05-28 |
| 1952573412 | Gail Patricia Petrosky | Dentist | 225 Gordons Corner Road, Suite 2e, Manalapan, NJ 07726 | 2008-03-25 |
| Find all providers with the same taxonomy | ||||
| City | NEW BRUNSWICK |
| Zip Code | 08901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.