Active NPI
Monica Madhuri Jolly, DMD
- General Practice Dentistry
- South Richmond Hill, NY
National Provider Identifier
1649527250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 056262
- Practice address
- 11407 101St Ave
South Richmond Hill, NY 11419-1138 - Phone
- (504) 669-1304
- NPI assigned
- Aug 14, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 056262 | NY | Primary |
Addresses
Primary practice location
11407 101St Ave
South Richmond Hill, NY 11419-1138
Mailing address
11407 101St Ave
South Richmond Hill, NY 11419-1138
Phone (504) 669-1304
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 |
|---|---|---|---|
| 056262 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459900800000",
"number": "1649527250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11407 101ST AVE",
"city": "SOUTH RICHMOND HILL",
"state": "NY",
"postal_code": "114191138",
"telephone_number": "504-669-1304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11407 101ST AVE",
"city": "SOUTH RICHMOND HILL",
"state": "NY",
"postal_code": "114191138",
"telephone_number": "504-669-1304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLY",
"first_name": "MONICA",
"middle_name": "MADHURI",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-14",
"last_updated": "2016-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "056262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Richmond Hill, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.