Ricky Lee Larson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25396 Issued in TX

Practice address

546 E Sandy Lake Rd Ste 240
Coppell, TX 75019-5790

Phone

(972) 304-0489

Fax

(972) 745-6799

NPI assigned

Jul 1, 2009

Last updated

Oct 2, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1255569927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 E SANDY LAKE RD STE 240",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750195790",
            "telephone_number": "972-304-0489",
            "fax_number": "972-745-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 E SANDY LAKE RD STE 240",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750195790",
            "telephone_number": "972-304-0489",
            "fax_number": "972-745-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "RICKY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Marie Land
• Rebecca Lander, RN, BSN, IBCLC
• Andrew William Landry
• Alexander Lao, DPT
• Maricela Lara-Nevarez, PHARMD, RPH
• Las Colinas Primary Care PLLC
• Rhiannon Laumas
• Laura a Pels (Coppell Vision Center)
• Lavene Counseling PLLC
• Aiyana Leigh Petronella Layne

• General Practice Dentistry in Coppell, TX
• Providers in Coppell, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.