Benjamin David Larson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13581 Issued in MN

Practice address

6601 Lyndale Ave S
Richfield, MN 55423-2477

Phone

(612) 866-1234

NPI assigned

Jul 1, 2015

Sex

Male

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1356724975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MELBOURNE AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 LYNDALE AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232477",
            "telephone_number": "612-866-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Xochitl Lara, APRN, CNP
• Emily Larenzie, OTD, OTR/L
• James P Laroy, MD
• Larson Phcy Inc
• Ashli Larson
• Brent James Larson, DPM
• Julie Larson
• Ngoc-Thanh T Le, APRN, FNP-C
• Thao Phuoc Le, DDS
• Michael J Legris, M.D.

• General Practice Dentistry in Richfield, MN
• Providers in Richfield, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.