Kimball L Larsen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10269 Issued in WA

Practice address

216 N Edison St
Kennewick, WA 99336-1956

Phone

(509) 737-0327

Fax

(509) 737-1360

NPI assigned

Feb 20, 2007

Sex

Male

Sole proprietor

No

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.

• Csdental, PLLC

  • General Practice Dentistry
  • Kennewick, WA
  • NPI 1679642151

  General Practice

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2007.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1215072087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 N EDISON ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361956",
            "telephone_number": "509-737-0327",
            "fax_number": "509-737-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N EDISON ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361956",
            "telephone_number": "509-737-0327",
            "fax_number": "509-737-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "KIMBALL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "10269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5052162",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles D Lansing, D.D.S.
• Dena M Larkin, RN
• Larry G. Swisher DDS PS
• Larry W Loveridge, DMD, PLLC
• Anthony Lynn Larsen, LMHC
• Meagan Larsen
• Deanna Larson
• Kimberly Raquell Larson, ARNP
• Vivian Larson, RN
• Lasting Harmony LLC

• All providers in Kennewick, WA
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.