Lara Inga Larson, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

5846 Issued in NE

Practice address

96TH Dental Squadron
307 Boatner Avenue
Eglin Afb, FL 32542

Phone

(850) 883-8052

NPI assigned

Sep 30, 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

Other names 1

• Dr. Lara Inga Vanderyacht Former name

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1346237864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 GRACIE LANE",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96TH DENTAL SQUADRON",
            "address_2": "307 BOATNER AVENUE",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "32542",
            "telephone_number": "850-883-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "LARA",
        "middle_name": "INGA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NE",
            "license": "5846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARA",
            "last_name": "VANDERYACHT",
            "middle_name": "INGA",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Glenn L. Laird, PHARM.D.
• Kevin Lampron
• Thomas Langley
• Kelly Ann Langsten, R.D.H.
• Robert E Langsten, DDS, ABGD,FAGD
• Jamie Lynn Blanchard Lassiter, M.A., CCC-SLP
• David Patrick Laughlin, DO
• Peter Laughlin, D.D.S.
• Danielle Lawton, AGCNS-BC
• Jennifer Lynne Lazarowicz, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.