NPIMap

Organization Active NPI

Bryant & Larson. a Professional Dental Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Riverside, CA
National Provider Identifier
1245965797
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
BRYANT & LARSON. A PROFESSIONAL DENTAL CORPORATION
Practice address
6886 Indiana Ave Ste a
Riverside, CA 92506-4218
Phone
(951) 686-6410
NPI assigned
Jul 19, 2022
Organization subpart
Yes
Parent organization
LARSON ORTHODONTICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Dr. Marc R Larson, DDSNPI 1356437354
Title
Owner/Provider
Phone
(951) 686-6410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

6886 Indiana Ave Ste a
Riverside, CA 92506-4218

Mailing address

6886 Indiana Ave Ste a
Riverside, CA 92506-4218
Phone (951) 686-6410

Other practice location 1

580 N Main St
Corona, CA 92878-4043
Phone (951) 686-6410

Other names 1

  • Larson Orthodontics Doing business as

National Provider Directory

National Provider Directory
Part of
Bryant Larson a Professional Dental Corporation

Locations

580 N Main St
Corona, CA 92878
Phone (951) 686-6410

6886 Indiana Ave
Ste A
Riverside, CA 92506
Phone (951) 686-6410

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1245965797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6886 INDIANA AVE STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064218",
            "telephone_number": "951-686-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6886 INDIANA AVE STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064218",
            "telephone_number": "951-686-6410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 N Main St",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928784043",
            "country_code": "US",
            "telephone_number": "951-686-6410",
            "fax_number": "951-680-1755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRYANT & LARSON. A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LARSON ORTHODONTICS",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "951-686-6410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Larson Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Larson Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.