Southern Tier Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SOUTHERN TIER DENTISTRY

Practice address

133 E Fairmount Ave
Lakewood, NY 14750-1950

Phone

(716) 763-6823

Fax

(716) 763-0341

NPI assigned

Aug 22, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Winchester Logan Stuart, DDS

Title

Partner

Phone

(716) 763-6823

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• S Michael Johnson, D.D.S.

  • General Practice Dentistry
  • Lakewood, NY
  • NPI 1962622944
  NPD (past)
• Shelby Rauh

  • General Practice Dentistry
  • Falconer, NY
  • NPI 1841931888
  NPD (past)

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1083195754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E FAIRMOUNT AVE",
            "city": "LAKEWOOD",
            "state": "NY",
            "postal_code": "147501950",
            "telephone_number": "716-763-6823",
            "fax_number": "716-763-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E FAIRMOUNT AVE",
            "city": "LAKEWOOD",
            "state": "NY",
            "postal_code": "147501950",
            "telephone_number": "716-763-6823",
            "fax_number": "716-763-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "STUART",
        "authorized_official_first_name": "WINCHESTER",
        "authorized_official_middle_name": "LOGAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "716-763-6823",
        "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": []
}

• Jon Scroxton, PT, DPT
• Syed Ali Raza Shamsi, M.B.B.S.
• Mark E Simons, RPH
• David C Smith, DPM
• Alicia J Snow, PA-C
• Southern Tier Nurse Practitioners in Psychiatry
• Step Forward Applied Behavior Analysis PLLC
• Eylessia Florintina Stilson
• Bonnelynn Marie Swanson, CCC-SLP
• Michael Philip Swanson, RPH

• Dental Clinic/Center in Lakewood, NY
• Providers in Lakewood, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.