Stacy Lynn Larsen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6283 Issued in NE

Practice address

Department of the Army Dental Activity Stop
2817 Reilly Rd, MCDS-NA-B
Fort Bragg, NC 28310-0001

Phone

(910) 396-5610

Fax

(910) 396-7017

NPI assigned

Dec 28, 2005

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213315200000",
    "number": "1336126697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF THE ARMY DENTAL ACTIVITY STOP",
            "address_2": "2817 REILLY RD, MCDS-NA-B",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-396-5610",
            "fax_number": "910-396-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF THE ARMY DENTAL ACTIVITY STOP",
            "address_2": "2817 REILLY RD, MCDS-NA-B",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-396-5610",
            "fax_number": "910-396-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2008-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrt Jon Lantz, O.D.
• Aaron Lapointe
• Bradley William Lapointe, DDS
• Helen Laquay
• Michael Laroche, PA-C
• Anna E Larson, DO
• April Ann Lassa, APNP
• Bradley J Lassa, CRNA
• Michelle Simpson Laurich, PHARMD
• Michele L Lautzenheiser, DDS

• General Practice Dentistry in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.