St Lawrence Dental Studio PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

052242 Issued in NY

Legal business name

ST LAWRENCE DENTAL STUDIO PLLC

Practice address

14 Miner St
Canton, NY 13617-1286

Phone

(315) 379-9195

NPI assigned

Dec 3, 2009

Last updated

Dec 3, 2009By 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

Dr. Aleksandr Medved, DDSNPI 1659418002

Title

Operating Manager

Phone

(315) 379-9195

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, and the practitioner matching its NPPES authorized official.

• Aleksandr Medved, DDS

  • General Practice Dentistry
  • Canton, NY
  • NPI 1659418002
  NPD (past) Authorized official
• Yuliya Medved, DDS

  • General Practice Dentistry
  • Canton, NY
  • NPI 1326186503
  NPD (past)

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1922336973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 MINER RD",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129536103",
            "telephone_number": "518-483-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MINER ST",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171286",
            "telephone_number": "315-379-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LAWRENCE DENTAL STUDIO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-03",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "MEDVED",
        "authorized_official_first_name": "ALEKSANDR",
        "authorized_official_title_or_position": "OPERATING MANAGER",
        "authorized_official_telephone_number": "315-379-9195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Lawrence County (St Lawrence County Public Health Department - EI)
• St Lawrence County
• St Lawrence County (St Lawrence County Public Health - Clinic)
• St Lawrence County (St Lawrence County Public Health l- EL SC MA)
• St Lawrence County Public Health Department
• St. Lawrence County CDP
• St. Lawrence County Community Development Program
• St. Lawrence Nysarc
• Matthew L. Stock, PA
• Megan Ashley Stone, RDH

• Dentist in Canton, NY
• Providers in Canton, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; 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.