Individual provider Active NPI

Marc Larson, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Riverside, CA
National Provider Identifier
1356437354
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
47275 Issued in CA
Practice address
6886 Indiana Ave Ste a
Riverside, CA 92506-4218
Phone
(951) 686-6410
Fax
(951) 680-1755
NPI assigned
Oct 5, 2006
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 47275 CA Primary

Addresses

Primary practice location

6886 Indiana Ave Ste a
Riverside, CA 92506-4218

Mailing address

6886 Indiana Ave Ste a
Riverside, CA 92506-4218
Phone (951) 686-6410

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address office@larsonortho.net 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

State licenses

LicenseStateTypeSpecialty
47275CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bryant & Larson. a Professional Dental Corporation Orthodontics and Dentofacial Orthopedics CurrentSince Jul 24, 2022 Accepting new patients
Marc R Larson DDS Ms a Dental Corporation Current Accepting new patients
Chokka Dental Corporation Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Locations

6886 Indiana Ave
Ste A
Riverside, CA 92506
Phone (951) 686-6410

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1356437354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6886 INDIANA AVE STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064218",
            "telephone_number": "951-686-6410",
            "fax_number": "951-680-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6886 INDIANA AVE STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064218",
            "telephone_number": "951-686-6410",
            "fax_number": "951-680-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "47275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@larsonortho.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6886 Indiana Ave Ste A",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925064218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.