Keith R Larson DMD PC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

D4338 Issued in OR

Legal business name

KEITH R LARSON DMD PC

Practice address

17895 NW Evergreen Pkwy
130
Beaverton, OR 97006-7402

Phone

(503) 716-6712

Fax

(503) 536-6617

NPI assigned

Oct 1, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Keith Rodney Larson, DMD, PC

Title

Owner

Phone

(503) 292-0416

Specialties & licenses 1

Addresses

Other names 1

• Apnea and Snoring Doing business as

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508457600000",
    "number": "1093185118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17895 NW EVERGREEN PKWY",
            "address_2": "130",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067402",
            "telephone_number": "503-716-6712",
            "fax_number": "503-536-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17895 NW EVERGREEN PKWY",
            "address_2": "130",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067402",
            "telephone_number": "503-716-6712",
            "fax_number": "503-536-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH R LARSON DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-01",
        "last_updated": "2017-10-20",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "RODNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-292-0416",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, PC"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "OR",
            "license": "D4338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apnea and Snoring",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dylan Kearl
• Emma K Keefe
• Lindsay Keefner, APC
• Helen E Keene
• Mackensie Marie Keiner, MSW, CSWA, QMHP
• Tyler Keliiheleua, N.D.
• Bridget Keller
• David Larsen Keller, DMD
• Stephanie Michelle Keller
• Cathryn Grace Kellett

• Customized Equipment (DME) in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Customized Equipment (DME) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; 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.