BAY STATE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.C. (NPI# 1821153586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821153586 |
| Entity Type | Organization |
| Organization Name | BAY STATE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.C. |
| Other Organization Name | JOHN M RISTUCCIA, DDS AND ASSOCIATES, PC |
| Practice Address |
100 Amesbury St Suite 112 Lawrence MA 01840-1321 |
| Practice Telephone | 9786864187 |
| Practice Fax Number | 9786860941 |
| Mailing Telephone | 9786864187 |
| Mailing Fax Number | 9786860941 |
| Enumeration Date | 2006-12-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOHN MICHAEL RISTUCCIA (PRESIDENT) |
| Authorized Official Telephone | 9786864187 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
11590 | MA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BLUE CROSS BLUE SHIELD | X10821 | 01 |
| MA | TUFTS HEALTH PLAN | 600593 | 01 |
| MA | UNITED CONCORDIA | 585304 | 01 |
| MA | TUFTS HEALTH PLAN | 689643 | 01 |
| MA | CIGNA HEALTHCARE | 0024745 | 01 |
| MA | BLUE CROSS BLUE SHIELD | M11729 | 01 |
| Other Name | Type Code |
|---|---|
| John M Ristuccia, DDS and Associates, PC | Former Legal Business Name - Organization |
| Street Address |
100 AMESBURY ST SUITE 112 |
| City | LAWRENCE |
| State | MA |
| Zip Code | 01840-1321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568460483 | Jonathan K Gordon | Surgery | 100 Amesbury St, Suite 113, Lawrence, MA 01840-1321 | 2005-07-13 |
| 1184075038 | Merrimack Valley Orthodontics LLC | Dentist | 100 Amesbury St, Suite 110, Lawrence, MA 01840-1321 | 2016-06-22 |
| 1538534953 | James F. Drew Dmd PC | Preferred Provider Organization | 100 Amesbury St, Lawrence, MA 01840-1321 | 2015-12-10 |
| 1619347747 | Federico Jose Perez | Dentist | 100 Amesbury St, #203, Lawrence, MA 01840-1321 | 2015-10-01 |
| 1588032395 | Xingxue Hu | Dentist | 100 Amesbury St, St #203, Lawrence, MA 01840-1321 | 2015-09-10 |
| 1235542903 | Audra Buckley Reynoso | Dentist | 100 Amesbury St, Suite 110, Lawrence, MA 01840-1321 | 2014-06-10 |
| 1689950420 | Ingrid Pena De Carreno | Dentist | 100 Amesbury St, Lawrence, MA 01840-1321 | 2011-10-25 |
| 1366757064 | Cathleen E. Wallent, Dmd, PC | Dentist | 100 Amesbury St, Suite 202, Lawrence, MA 01840-1321 | 2010-08-18 |
| 1255663043 | Sandra Ameri | Dentist | 100 Amesbury St, Suite 203, Lawrence, MA 01840-1321 | 2010-02-04 |
| 1922265339 | Maritza Morell Dmd PC | Dentist | 100 Amesbury St, Suite 111, Lawrence, MA 01840-1321 | 2008-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487293569 | Cure-aid Pharmacy Inc | Pharmacy | Cure-aid Pharmacy, 203 Essex Street, Lawrence, MA 01840 | 2020-01-06 |
| 1053819482 | Allied Pharmacy Inc. | Pharmacy | 10-12 Hampshire Street, Lawrence, MA 01840 | 2018-01-31 |
| 1720598626 | Natalie Perez | Counselor | 15 South Union St, 200, Lawrence, MA 01840 | 2017-10-05 |
| 1932636271 | Iluminada De La Cruz | Counselor | 2 Museum Square Apt 412, Lawrence, MA 01840 | 2017-05-17 |
| 1831642867 | Karina Tremiti | Counselor | 599 Canal St, 5th Fl, Lawrence, MA 01840 | 2016-07-26 |
| 1467733717 | Suzanne Beth Macphail | Counselor | 11 Union Street, Lawrence, MA 01840 | 2011-08-31 |
| 1831416767 | Db Practice Management, Inc | Dentist | 488 Essex St, Lawrence, MA 01840 | 2010-05-03 |
| 1033341169 | Michele Davis | Counselor | 15 Union Street, Second Floor, Lawrence, MA 01840 | 2009-08-24 |
| 1447401856 | Erin Grace Mooney | Social Worker | 439 South Union Street, Suite 207a, Lawrence, MA 01840 | 2008-10-03 |
| 1215127840 | Marcia Elaine Nelson-vancini | Nurse Practitioner | Lahey Health Behavioral Services, Inc., 12 Methuen Street, Lawrence, MA 01840 | 2007-07-30 |
| Find all providers in zip 01840 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114106739 | S Kirk Vincent D.d.s., L.c. | Dentist | 4811 Bob Billings Parkway, Suite A, Lawrence, KS 66049 | 2007-10-31 |
| 1174653042 | Lori Dawn Cohen | Dentist | 285 Central Ave, Suite F-3, Lawrence, NY 11559-1535 | 2007-03-07 |
| 1144324278 | Stephen Kirk Vincent | Dentist | 4811 Bob Billings Pkwy, Suite A, Lawrence, KS 66049-3851 | 2006-09-11 |
| 1134233547 | Joseph M Harvey | Dentist | 308 Maine St, Lawrence, KS 66044 | 2006-08-19 |
| 1427162833 | Philip C Gaus Jr. | Dentist | 4901 Legends Dr, Lawrence, KS 66049-5800 | 2006-08-19 |
| 1457388092 | Scott Paul Barber | Dentist | 4811 Bob Billings Pkwy Ste A, Lawrence, KS 66049-3853 | 2006-06-27 |
| 1215544184 | Scott Barber, Dds, Pa | Dentist | 4811 Bob Billings Parkway, Suite A, Lawrence, KS 66049 | 2020-09-25 |
| 1336550607 | Wakashaw, LLC | Dentist | 4901 Legends Dr, Lawrence, KS 66049-5800 | 2014-05-08 |
| 1306076971 | Wakarusa Oral Surgery, Lc | Dentist | 4901 Legends Dr, Lawrence, KS 66049-5800 | 2009-07-17 |
| 1689877284 | Dmitry Y. Tsvetov | Dentist | 73c Winthrop Ave, Lawrence, MA 01843-3716 | 2007-06-09 |
| Find all providers in LAWRENCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.