Larsen Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1599 Issued in ID

Legal business name

LARSEN DENTAL CARE

Practice address

950 Hospital Way
Suite B
Pocatello, ID 83201-2789

Phone

(208) 233-7007

NPI assigned

Mar 24, 2008

Last updated

Mar 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Danielle Mabey

Title

Office Manager

Phone

(208) 233-7007

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bryce Robert Larsen, D.M.D.

  • General Practice Dentistry
  • Pocatello, ID
  • NPI 1821210535
  NPD (past)
• Niels Willard Larsen V, D.D.S.

  • General Practice Dentistry
  • Pocatello, ID
  • NPI 1770796070
  NPD (past)

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1285806844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 HOSPITAL WAY",
            "address_2": "SUITE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012789",
            "telephone_number": "208-233-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 HOSPITAL WAY",
            "address_2": "SUITE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012789",
            "telephone_number": "208-233-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARSEN DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "MABEY",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-233-7007"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D1599",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3894",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8072105",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Bradford Lane Jr., LPC
• Cynthia L Lange, LPC
• Bryan Lankford, LPC
• Chasen Larinto
• Larsen Dental Care
• Bryce Robert Larsen, D.M.D.
• David J Larsen, M.D.
• Joseph Val Larsen
• Niels Willard Larsen V, D.D.S.
• Steven Allen Larsen, MD

• General Practice Dentistry in Pocatello, ID
• Providers in Pocatello, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.