Don Wilhelm Larson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D21379 Issued in CA

Practice address

916 Center St
Santa Cruz, CA 95060-3808

Phone

(831) 423-7530

NPI assigned

Sep 21, 2007

Sex

Male

Sole proprietor

Yes

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 CA

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": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1376739417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 CENTER ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603808",
            "telephone_number": "831-423-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 CENTER ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603808",
            "telephone_number": "831-423-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "DON",
        "middle_name": "WILHELM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "D21379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingrid Lariviere
• Jedidiah Delano Laroque
• Nicholas Larry
• Sophia Kaj Larsen
• Lonna Larsh, M.D.
• Greg Larson
• Katie Rae Larson
• Satu Alisa Larson, CPNP
• Sloan Pearce Larson, NP-C
• Thomas Larson

• General Practice Dentistry in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.