Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jeremiah Edillor Juson, DMD

Individual provider Dentist · NPI 1265766315

Dr. Jeremiah Edillor Juson, DMD is a Dentist in Long Island City, New York. Works from 2 locations. Licensed in Massachusetts and New York.

Licensed in
MA, NY
In the registry since
2009
Specialties on file
3
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

2301 Queens Plz N Ste C
Long Island City, NY 11101
Phone: (508) 679-8111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 225 E 64th St Ste 1, New York, NY 10065-6684 — (212) 803-3345

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X · Licence 059613 (NY)
Dentist Taxonomy 122300000X · Licence DL11820 (MA)
Orthodontics and Dentofacial Orthopedics Dentistry Taxonomy 1223X0400X · Licence DL11820 (MA)

Record details

NPI number1265766315
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedSeptember 22, 2009
Last updated in NPPESMarch 7, 2023
Certification dateJanuary 4, 2021

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