St. Lawrence Oral and Maxillofacial Surgery Associates PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ST. LAWRENCE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES PC

Practice address

14 Elm St Ste B
Potsdam, NY 13676-1945

Phone

(315) 265-1761

Fax

(315) 265-1768

NPI assigned

Mar 26, 2007

Last updated

Oct 7, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michaela Muniz

Title

VP, Payor Relations

Phone

(469) 324-3242

Specialties & licenses 2

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, and the practitioner matching its NPPES authorized official.

• Erhard Alfred Beuttenmuller, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Fort Drum, NY
  • NPI 1578554119
  NPD
• Lawrence E. Way, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Watertown, NY
  • NPI 1932199635
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1851419287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 ELM ST STE B",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761945",
            "telephone_number": "315-265-1761",
            "fax_number": "315-265-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 ELM ST STE B",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761945",
            "telephone_number": "315-265-1761",
            "fax_number": "315-265-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LAWRENCE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "MUNIZ",
        "authorized_official_first_name": "MICHAELA",
        "authorized_official_title_or_position": "VP, PAYOR RELATIONS",
        "authorized_official_telephone_number": "469-324-3242"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01456399",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim L. Sprague, RPH
• Mallory Sprague, MD
• St Lawerence Oral and Maxilliofacial Surgery
• St Lawrence Radiology Assoc PC
• St. Lawrence Cardiology
• St. Lawrence Orthopedics Specialists PC
• Amy St.Hilaire, RN
• Bethany L St.Hilaire
• Sarah Stanton
• State Hearing and Audiology, PC

• Oral and Maxillofacial Surgery (Dentist) in Potsdam, NY
• Providers in Potsdam, 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 Oct 7, 2026; 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.