Larry K Heggerness, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3688 Issued in WA

Practice address

4110 Kitsap Way Ste 100
Bremerton, WA 98312-2401

Phone

(360) 479-8822

Fax

(360) 479-3565

NPI assigned

Feb 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053446435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 KITSAP WAY STE 100",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983122401",
            "telephone_number": "360-479-8822",
            "fax_number": "360-479-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 KITSAP WAY STE 100",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983122401",
            "telephone_number": "360-479-8822",
            "fax_number": "360-479-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEGGERNESS",
        "first_name": "LARRY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "3688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Heaton
• Julia Heberling
• Thaddeus Heberling
• Carolina Hector, MSN-ED, RN, PMH-BC
• Kathy M. Heggenstaller, S.W.
• Keith Edward Heino, RPH
• Nicholas John William Heino, SUDPT
• Charliss Mimi Held, O.D.
• Jillian Helton
• Anthony Henderson

• General Practice Dentistry in Bremerton, WA
• Providers in Bremerton, WA by specialty
• General Practice Dentistry in Washington

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.