Crystal Marie Larrew, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

109485 Issued in CA

Practice address

585 N Mountain Ave Ste C
Upland, CA 91786-8516

Phone

(909) 985-5117

NPI assigned

Sep 25, 2023

Last updated

Sep 25, 2023By the provider in NPPES

Sex

Female

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

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1538948955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26311 ANTONIO CIR",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923546731",
            "telephone_number": "423-488-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 N MOUNTAIN AVE STE C",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868516",
            "telephone_number": "909-985-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARREW",
        "first_name": "CRYSTAL MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Houman Langroodi, DDS
• Wilson Dugaduga Lao, MD
• Martha Libertad Lara, M.D.
• Samuel Lardizabal, M.D.
• James Richard Larose, DPM
• Heidi Noel Larson, RN, MSN, FNP-C.
• Pui Tan Lau, MS, RDN
• Tracy Lau, PHARMD
• Tse Ling Lau
• Laurel House Icf (Laurel House)

• General Practice Dentistry in Upland, CA
• Providers in Upland, 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 25, 2023; 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.