Larissa Ann Delo, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DS-028583-L Issued in PA

Practice address

6 Niles Hill Rd
Coudersport, PA 16915-1211

Phone

(814) 274-1111

NPI assigned

Dec 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr. Victor D. Brown, DMD, LLC

  • Dentist
  • Coudersport, PA
  • NPI 1336493451
  NPD (past)

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1114081874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 NILES HILL RD",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169151211",
            "telephone_number": "814-274-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 NILES HILL RD",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169151211",
            "telephone_number": "814-274-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELO",
        "first_name": "LARISSA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-028583-L",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS-028583-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "0015085930002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Jon D'Agostino, PA-C
• Darling Apothecary, LLC
• Rachel Marie Darrah, CRNP
• Melanie Sue Darush
• Jennifer Davis, RD, LDN
• Shelby Dietze
• Dawn Yvonne Dovensky, LCSW
• Dr. Victor D. Brown, DMD, LLC
• John Paul Dresser, DPM
• Sara Elizabeth Drummond

• Dentist in Coudersport, PA
• Providers in Coudersport, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.