Jeremy M. Starr, DDS, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JEREMY M. STARR, DDS, INC.

Doing business as

Roseville Wisdom Teeth

Practice address

927 Reserve Dr Ste B
Roseville, CA 95678-1383

Phone

(916) 945-9599

Fax

(916) 945-0123

NPI assigned

Apr 21, 2021

Last updated

Apr 21, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Martin Starr, DDSNPI 1508298514

Title

Ceo

Phone

(916) 769-8486

Specialties & licenses 1

Addresses

Other names 1

• Roseville Wisdom Teeth Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeremy Martin Starr, D.D.S.

  • General Practice Dentistry
  • Rocklin, CA
  • NPI 1508298514
  NPD Authorized official

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1871174730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 PRINCESS CT",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957654769",
            "telephone_number": "916-769-8486",
            "fax_number": "916-945-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 RESERVE DR STE B",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956781383",
            "telephone_number": "916-945-9599",
            "fax_number": "916-945-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY M. STARR, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "STARR",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-769-8486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roseville Wisdom Teeth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Valerie James Jennings
• Jessica Lorraine Jeno, M.A., BCBA
• Amanda Jane Jensen
• Nathan Jensen
• Jeremy Juern MD
• Delaina Marie Jewkes, M.D.
• Xiaojuan Jiang
• Jibson Family Counseling
• Kristin Jibson
• Ryan Jibson, MSW

• Dental Clinic/Center in Roseville, CA
• Providers in Roseville, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.