Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jairo Bastidas, DMD

Individual provider Oral and Maxillofacial Surgery (Dentist) · NPI 1780763300

Dr. Jairo Bastidas, DMD is a Maxillofacial Surgery in Bronx, New York. Qualified in 1987, 39 years ago. Practices with Montefiore Medical Center, a 2,796-clinician group. Licensed in New York.

Years since qualifying
39
Licensed in
NY
In the registry since
2006
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

111 E 210th St
Bronx, NY 10467-2401
Phone: (718) 920-4167
Fax: (718) 515-5419
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 041328 (NY)

Record details

NPI number1780763300
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedNovember 3, 2006
Last updated in NPPESJuly 8, 2007
Mailing address90 Palisade Ave, White Plains, NY 10607-2725

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMAXILLOFACIAL SURGERY
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Group practice Montefiore Medical Center — 2796 clinicians
Accepts Medicare assignment Not indicated

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