Katie Miettunen Larson, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

6790015 Issued in WI

Practice address

2966 Meadowlark Lane
Altoona, WI 54720

Phone

(715) 514-3333

NPI assigned

Nov 29, 2011

Last updated

Nov 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Katie Elizabeth Miettunen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Larson Orthodontic Specialists

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Eau Claire, WI
  • NPI 1851667364
  NPD (past)

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637884800000",
    "number": "1508133901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2966 MEADOWLARK LANE",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "54720",
            "telephone_number": "715-514-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2966 MEADOWLARK LANE",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "54720",
            "telephone_number": "715-514-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KATIE",
        "middle_name": "MIETTUNEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-29",
        "last_updated": "2021-11-26",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D13027",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "6790015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "MIETTUNEN",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "D.D.S., M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janna Krula, PT, DPT
• Amy Marie Kurtz, PT
• Chanrachna Ladin, FNP
• Brett Joseph Ladsten, PT, DPT
• Tanya Marie Langan, OTR/L
• Matthew Evans Larson, DDS, MS
• Brooklyn Marie Laube, DPT
• Tiffany Leighton-Giffey, SLP
• Catlyn Li Volsi, BCBA
• Katrina Lynn Lindner, PTA

• Orthodontics and Dentofacial Orthopedics Dentistry in Altoona, WI
• Providers in Altoona, WI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2021; 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.