Kristopher Bryce Larson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D009505 Issued in AZ

Practice address

4050 E Huber St
Mesa, AZ 85205-4022

Phone

(801) 921-0792

NPI assigned

Sep 23, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1114396751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 E HUBER ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054022",
            "telephone_number": "801-921-0792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 E HUBER ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054022",
            "telephone_number": "801-921-0792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KRISTOPHER",
        "middle_name": "BRYCE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-23",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00202672",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D009505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Jay Larson, ATC
• Ayn Larson, PA
• Jason Rex Larson, CRNA
• Jennifer Larson, DNP, CNM, CPM
• Jennifer L Larson, PT, DPT, LMT, CERTDN
• Rhonda Dalene Larson, LM CPM
• Stephanie Ann Larson
• Tammy Larson
• Trent Larson, PHARMD
• Las Sendas Cardiology, PC

• Dentist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.