Northern Oral & Maxillofacial Surgery Services. P.C.

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

0314531 Issued in NY

Legal business name

NORTHERN ORAL & MAXILLOFACIAL SURGERY SERVICES. P.C.

Practice address

104 Paddock St
Suite 103
Watertown, NY 13601-3948

Phone

(315) 782-3101

Fax

(315) 782-3223

NPI assigned

Dec 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Lawrence Way, D.D.SNPI 1932199635

Title

President

Phone

(315) 782-3101

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Lawrence E. Way, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Watertown, NY
  • NPI 1932199635
  NPD (past) Authorized official
• Erhard Alfred Beuttenmuller, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Fort Drum, NY
  • NPI 1578554119
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811059892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 PADDOCK ST",
            "address_2": "SUITE 103",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PADDOCK ST",
            "address_2": "SUITE 103",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013948",
            "telephone_number": "315-782-3101",
            "fax_number": "315-782-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ORAL & MAXILLOFACIAL SURGERY SERVICES. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAY",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-782-3101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "0314531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01137613",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northern New York Gastroenterology
• Northern New York Obs LLC
• Northern Nurse Practitioners - Family Health PLLC
• Northern Ny Infus
• Northern Ny Infusion
• Northern Orthopedic Laboratory, Inc.
• Northern Radiology Associates, PC
• Northern Radiology Imaging Center, PLLC
• Northern Regional Center for Independent Living
• Amanda Nortz, OT

• Oral and Maxillofacial Pathology Dentistry in Watertown, NY
• Providers in Watertown, NY by specialty
• Oral and Maxillofacial Pathology Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.