Individual provider Active NPI

Ann Elizabeth Larsen, RDH BS

  • Dental Hygienist
  • Wheat Ridge, CO
National Provider Identifier
1366040156
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
000903174 Issued in CO
Practice address
4800 Tabor St
Wheat Ridge, CO 80033-2112
Phone
(303) 421-4161
NPI assigned
Oct 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 000903174 CO Primary

Addresses

Primary practice location

4800 Tabor St
Wheat Ridge, CO 80033-2112

Mailing address

1182 Camp Eden Rd
Golden, CO 80403-8630
Phone (303) 801-7569

Other names 1

  • Ann Larsen Professional name

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
000903174COMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1366040156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1182 CAMP EDEN RD",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804038630",
            "telephone_number": "303-801-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 TABOR ST",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332112",
            "telephone_number": "303-421-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "ANN",
        "middle_name": "ELIZABETH",
        "credential": "RDH BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "000903174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "LARSEN",
            "credential": "RDH BS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.