Stephen Joseph Larson, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

30022411 Issued in OH

Practice address

612 Rockdale Ave
Cincinnati, OH 45229-2919

Phone

(513) 352-4072

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033276357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 CINCINNATI BATAVIA PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452440249",
            "telephone_number": "513-528-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 ROCKDALE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452292919",
            "telephone_number": "513-352-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "STEPHEN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "OH",
            "license": "30022411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2679981",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jarrett Larson
• Jon Philip Larson, DDS
• Justice Larson
• Kirsten Marie Larson, LSW
• Peter Joseph Larson Jr., MD, PHD
• Therese Larson
• Laser Neck and Back Center LLC
• Laser Spine Institute, LLC
• Laser Spine Surgery Center of Cincinnati
• Lorraine Lash

• Public Health Dentistry in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Public Health Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.