Active NPI
Jennifer Margaret Merry, DMD
- Dentist
- Oswego, NY
National Provider Identifier
1780941906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 056740
- Practice address
- 12 New St
Oswego, NY 13126-1764 - Phone
- (315) 342-5800
- NPI assigned
- Apr 12, 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 056740 | NY | Primary |
Addresses
Primary practice location
12 New St
Oswego, NY 13126-1764
Mailing address
12 New St
Oswego, NY 13126-1764
Phone (315) 342-5800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03616488 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150624001929 | NY | Order and Referring Only - Dentist | 8022329572 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056740 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oswego Dental Health Associates, PLLC | 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.
-
- General Practice Dentistry
- Oswego, NY
- NPI 1982361531
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400544000000",
"number": "1780941906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 NEW ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131261764",
"telephone_number": "315-342-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 NEW ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131261764",
"telephone_number": "315-342-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRY",
"first_name": "JENNIFER",
"middle_name": "MARGARET",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-12",
"last_updated": "2014-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "056740",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03616488",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oswego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.