Individual provider Active NPI

Alicia Marie Larsen, RDH

  • Dental Hygienist
  • Geneva, NY
National Provider Identifier
1265165054
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
031238 Issued in NY
Practice address
140 Washington St
Geneva, NY 14456-2839
Phone
(315) 789-7922
NPI assigned
Jul 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 031238 NY Primary

Addresses

Primary practice location

140 Washington St
Geneva, NY 14456-2839

Mailing address

3231 Brand Rd
Clyde, NY 14433-9728
Phone (315) 604-7257

Other identifiers 1

IdentifierTypeStateIssuer
031238MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Hygiene@genevadds.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Interoperability endpoints

  • Direct secure messaging: hygiene@genevadds.com

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1265165054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 BRAND RD",
            "city": "CLYDE",
            "state": "NY",
            "postal_code": "144339728",
            "telephone_number": "315-604-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 WASHINGTON ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562839",
            "telephone_number": "315-789-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "ALICIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "031238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031238",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Hygiene@genevadds.com",
            "affiliation": "N",
            "endpointDescription": "direct business e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct business e-mail",
            "address_1": "140 Washington St",
            "city": "Geneva",
            "state": "NY",
            "country_code": "US",
            "postal_code": "144562839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.