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DR. JACOB DYLAN MERRYMAN DDS
NPI 1104089903
Dentist in Queensbury, NY

Active since July 02, 2008PECOS Enrolled
453 DIXON RD, SUITE #3, QUEENSBURY, NY 12804(518) 793-3553 Get Directions Write a Review

NPPES record last updated: July 30, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jacob Dylan Merryman Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACOB DYLAN MERRYMAN DDS (NPI 1104089903) is an individual dentist in Queensbury, New York, licensed in New York (50 054420) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104089903
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. JACOB DYLAN MERRYMANCredential: DDS
Location Address453 DIXON RD, SUITE #3Queensbury, NY 12804-1964
Mailing Address24 Pearl St, Apt #1Schuylerville, NY 12871-1407 · (518) 695-4692
Phone(518) 793-3553
Sole ProprietorYes
Enumeration DateJuly 2, 2008
Last NPPES UpdateJuly 30, 2009
✔ NPI 1104089903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in NY · 50 054420
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
453 DIXON RD, Queensbury, NY 12804
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacob Dylan Merryman Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

H.JOHNSCHUTZE DDS PC
Dentist
453 DIXON RD
QUEENSBURY, NY 12804
Warren County (518) 793-3553
WILLIAM DANIEL BILLINGTON DMD
Dentist
453 DIXON RD
QUEENSBURY, NY 12804
Warren County (518) 792-1108
MRS. LILIANNE N DOBERT LCSW-R
Social Worker (Clinical)
453 DIXON RD, BLDG 3 STE 8
QUEENSBURY, NY 12804
Warren County (518) 321-7429
MS. TRACI LEE PHILLIPS-PERKINS LCSW-R
Social Worker (Clinical)
453 DIXON RD, BLDG. 3 STE. 8
QUEENSBURY, NY 12804
Warren County (518) 420-7466
DR. MARK A FRANKLIN DDS
Dentist
453 DIXON RD, SUITE 5
QUEENSBURY, NY 12804
Warren County (518) 792-1108
PATRICK J. ESMOND DDS, PLLC
Dentist
453 DIXON RD, SUITE 5
QUEENSBURY, NY 12804
Warren County (518) 792-1108
DR. H JOHN SCHUTZE II DDS
Dentist (General Practice)
453 DIXON RD, STE 3
QUEENSBURY, NY 12804
Warren County (518) 793-3553
DR. JONATHAN MICHAEL SCHUTZE DMD
Dentist (General Practice)
453 DIXON RD, SUITE 3
QUEENSBURY, NY 12804
Warren County (518) 793-3553

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Merryman's NPI number?

The NPI number for Jacob Merryman is 1104089903. It was assigned to this individual provider in the NPPES registry on July 2, 2008.

Where is Jacob Merryman located?

Jacob Merryman practices at 453 Dixon Rd Suite #3, Queensbury, NY 12804. The listed phone number is (518) 793-3553.

What is Jacob Merryman's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Jacob Merryman enrolled in Medicare?

Yes. Jacob Merryman is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Merryman was last updated on July 30, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.