Larisa Anisimov, RDH
Individual provider Active NPI Dental Hygienist · Norwich, CT
NPI 1477590859 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1477590859
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 6403 (CT)
- Practice address
- 47 Town St
Norwich, CT 06360-2315 - Phone
- (860) 892-7042
- Fax
- (860) 892-7043
- NPI assigned
- Jun 2, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6403 | CT | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 6403 | CT | Yes |
Addresses
Primary practice location
47 Town St
Norwich, CT 06360-2315
Mailing address
47 Town St
Norwich, CT 06360-2315
Phone (860) 892-7042
Other providers in Norwich, CT
- Amy Lynne Anderson
- Christine Anderson
- Nancy Anderson
- Sophia Elizabeth Andrew
- Katherine Andrias
- Jackilyn Annelli
- Sherida Antonacci
- Maria Aponte
- James W Aree
- Amanda Armstrong
All providers in Norwich, CT · Dental Hygienist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.