Active NPI
Jeron Skerritt-Ryan, DDS
- Dentist
- Clinton, MD
National Provider Identifier
1114237211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12037
- Practice address
- 11910 Mary Catherine Dr
Clinton, MD 20735-1018 - Phone
- (240) 997-5007
- Fax
- (301) 203-6283
- NPI assigned
- Oct 7, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12037 | MD | Primary |
Addresses
Primary practice location
11910 Mary Catherine Dr
Clinton, MD 20735-1018
Mailing address
11910 Mary Catherine Dr
Clinton, MD 20735-1018
Phone (240) 997-5007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12037 | MD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golden Key Dental ,LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Clinton, MD
- NPI 1568855682
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286409600000",
"number": "1114237211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11910 MARY CATHERINE DR",
"city": "CLINTON",
"state": "MD",
"postal_code": "207351018",
"telephone_number": "240-997-5007",
"fax_number": "301-203-6283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11910 MARY CATHERINE DR",
"city": "CLINTON",
"state": "MD",
"postal_code": "207351018",
"telephone_number": "240-997-5007",
"fax_number": "301-203-6283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKERRITT-RYAN",
"first_name": "JERON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-07",
"last_updated": "2010-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "12037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.