Vitkus, Scutari & Cardoso Oral Surgery PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

045842-1 Issued in NY

Legal business name

VITKUS, SCUTARI & CARDOSO ORAL SURGERY PC

Practice address

4000 Medical Center Drive
Suite B13
Fayetteville, NY 13066-1537

Phone

(315) 671-4289

Fax

(315) 637-1261

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Pasquale Scutari Jr., DDSNPI 1407925837

Title

Oral Maxillofacial Surgeon

Phone

(315) 637-4476

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Pasquale Scutari Jr., DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • North Syracuse, NY
  • NPI 1407925837
  NPD (past) Authorized official
• Candace Rebecca Scruggs, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Camillus, NY
  • NPI 1679771547
  NPD

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1275618019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MEDICAL CENTER DRIVE",
            "address_2": "SUITE B13",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661537",
            "telephone_number": "315-671-4289",
            "fax_number": "315-637-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MEDICAL CENTER DRIVE",
            "address_2": "SUITE B13",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661537",
            "telephone_number": "315-671-4289",
            "fax_number": "315-637-1261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5109 W Genesee St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Camillus",
            "state": "NY",
            "postal_code": "130312372",
            "country_code": "US",
            "telephone_number": "315-671-4289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "578 Seneca St",
            "address_purpose": "LOCATION",
            "city": "Oneida",
            "state": "NY",
            "postal_code": "134212600",
            "country_code": "US",
            "telephone_number": "315-671-4289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7334 Buckley Rd",
            "address_purpose": "LOCATION",
            "city": "North Syracuse",
            "state": "NY",
            "postal_code": "132122657",
            "country_code": "US",
            "telephone_number": "315-671-4289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VITKUS, SCUTARI & CARDOSO ORAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2024-05-06",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "SCUTARI",
        "authorized_official_first_name": "PASQUALE",
        "authorized_official_title_or_position": "ORAL MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "315-637-4476",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "045842-1",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Vartabedian
• Tracy A Vaughn, RPA
• Linda Noonan Vause, MS, CRC
• Vihaan Behavioral Health for Psychiatric Services, PLLC
• Village of Fayetteville
• James M Vlassis, DDS
• Susan Marie Volles, NP
• Elizabeth M. Wade, L.C.S.W.
• Katey Waldon, NP
• Keith Paul Waldron, P.T.

• Oral and Maxillofacial Surgery (Dentist) in Fayetteville, NY
• Providers in Fayetteville, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.