Bay State Oral & Maxillofacial Surgery Associates, P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

11590 Issued in MA

Legal business name

BAY STATE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.C.

Practice address

100 Amesbury St
Suite 112
Lawrence, MA 01840-1321

Phone

(978) 686-4187

Fax

(978) 686-0941

NPI assigned

Dec 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John Michael Ristuccia, D.D.S.

Title

President

Phone

(978) 686-4187

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• John M Ristuccia, DDS and Associates, PC Former legal business name

Locations

Practitioners 2

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

• Karim E Berty, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Andover, MA
  • NPI 1174843114

  Oral and Maxillofacial Surgery

  NPD (past)
• Kieran F. Dowd, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Concord, MA
  • NPI 1386633550

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1166832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821153586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 AMESBURY ST",
            "address_2": "SUITE 112",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401321",
            "telephone_number": "978-686-4187",
            "fax_number": "978-686-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 AMESBURY ST",
            "address_2": "SUITE 112",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401321",
            "telephone_number": "978-686-4187",
            "fax_number": "978-686-0941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY STATE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RISTUCCIA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-686-4187",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "11590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "0024745",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "585304",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "M11729",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "600593",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "689643",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X10821",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John M Ristuccia, DDS and Associates, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Katrina Saulrieta Baumgartner, MD
• Leyna T Bautista X, MD
• Benjamin Bautz, MD
• Arnold Baven
• Victoria Baxter, CNP
• Beacon Primary Medicine, Inc.
• Kaleb Adam Beaudry
• Amy Noreen Beauregard, LPN
• Beautiful Minds Counseling, LLC
• Zoe Becker

• All providers in Lawrence, MA
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• 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.