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DR. CHARLES D RANDOLPH D.D.S.
NPI 1164589107
Dentist - General Practice in Mamaroneck, NY

Active since January 02, 2007PECOS Enrolled
875 MAMARONECK AVE, SUITE 302, MAMARONECK, NY 10543(914) 835-6004(914) 835-6055 Get Directions Write a Review

NPPES record last updated: February 3, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Charles D Randolph D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CHARLES D RANDOLPH D.D.S. (NPI 1164589107) is an individual general practice provider in Mamaroneck, New York, licensed in New York (028137) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164589107
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. CHARLES D RANDOLPHCredential: D.D.S.
Location Address875 MAMARONECK AVE, SUITE 302Mamaroneck, NY 10543-1900
Mailing Address875 Mamaroneck Ave, Suite 302Mamaroneck, NY 10543-1900 · (914) 835-6004 · Fax (914) 835-6055
Phone(914) 835-6004
Fax(914) 835-6055
Sole ProprietorYes
Enumeration DateJanuary 2, 2007
Last NPPES UpdateFebruary 3, 2014
✔ NPI 1164589107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NY · 028137
Definition
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.
875 MAMARONECK AVE, Mamaroneck, NY 10543
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Other Identifiers 1

Medicaid02577842NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Charles D Randolph D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10543 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CANCER SUPPORT TEAM
Home Health
875 MAMARONECK AVE, SUITE 204
MAMARONECK, NY 10543
Westchester County (914) 777-2777
DR. BURTON LORBER DMD
Dentist (General Practice)
875 MAMARONECK AVE, SUITE 100A
MAMARONECK, NY 10543
Westchester County (914) 835-6004
DR. LYDIA V MIHOVILOVIC-HUMES DDS
Dentist (General Practice)
875 MAMARONECK AVE, SUITE 302
MAMARONECK, NY 10543
Westchester County (914) 835-6001
DR. GLENFORD NAKPAWAN D.D.S.
Dentist
875 MAMARONECK AVE, SUITE 100A
MAMARONECK, NY 10543
Westchester County (914) 835-6004
SARAH BLOUGH M.ED.
Specialist
875 MAMARONECK AVE
MAMARONECK, NY 10543
Westchester County (914) 337-3026
MS. NICOLE GREEN MSED
Specialist
875 MAMARONECK AVE
MAMARONECK, NY 10543
Westchester County (914) 337-3026
DR. VITO ELISEO DIMATTEO DC
Chiropractor (Sports Physician)
875 MAMARONECK AVE, SUITE102
MAMARONECK, NY 10543
Westchester County (914) 381-7575
DR. JACQUELINE A SOBOTA DMD, PHD
Dentist (General Practice)
875 MAMARONECK AVE, SUITE 302
MAMARONECK, NY 10543
Westchester County (914) 835-6004

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Randolph's NPI number?

The NPI number for Charles Randolph is 1164589107. It was assigned to this individual provider in the NPPES registry on January 2, 2007.

Where is Charles Randolph located?

Charles Randolph practices at 875 Mamaroneck Ave Suite 302, Mamaroneck, NY 10543. The listed phone number is (914) 835-6004.

What is Charles Randolph's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Charles Randolph enrolled in Medicare?

Yes. Charles Randolph is registered in the Medicare PECOS enrollment system.

What insurance does Charles Randolph accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Humana list Charles Randolph as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Charles Randolph was last updated on February 3, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.