Individual provider Active NPI

Jeremy David Montrose, DMD

  • Dentist
  • New York, NY
National Provider Identifier
1750695417
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
060852 Issued in NY
Practice address
54 W 21St St RM 308
New York, NY 10010-7370
Phone
(332) 242-7332
NPI assigned
Aug 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 060852 NY Primary

Addresses

Primary practice location

54 W 21St St RM 308
New York, NY 10010-7370

Mailing address

54 W 21St St RM 308
New York, NY 10010-7370
Phone (332) 242-7332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161026002865 OR Order and Referring Only - DentistPractitioner - Dentist 3678851623

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
060852NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeremy Montrose Dentistry PLLC Dentist Current Accepting new patients

Locations

54 W 21st St
Rm 308
New York, NY 10010
Phone (332) 242-7332

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFDIDD/Endpoint/BFDIDD

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1750695417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 W 21ST ST RM 308",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100107370",
            "telephone_number": "332-242-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 W 21ST ST RM 308",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100107370",
            "telephone_number": "332-242-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTROSE",
        "first_name": "JEREMY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-04",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "060852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.