Active NPI
Byron Larsen, DDS
- General Practice Dentistry
- Glendale, AZ
National Provider Identifier
1558568352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901018657
- Practice address
- 6120 W Bell Rd
Ste 180
Glendale, AZ 85308-3781 - Phone
- (602) 298-7200
- Fax
- (602) 298-7202
- NPI assigned
- Jun 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901018657 | MI | Primary |
Addresses
Primary practice location
6120 W Bell Rd
Ste 180
Glendale, AZ 85308-3781
Mailing address
6120 W. Bell Rd
Ste 180
Glendale, AZ 85308
UM
Phone (602) 298-7200
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901018657 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216166400000",
"number": "1558568352",
"addresses": [
{
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "6120 W. BELL RD",
"address_2": "STE 180",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85308",
"telephone_number": "602-298-7200",
"fax_number": "602-298-7202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6120 W BELL RD",
"address_2": "STE 180",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853083781",
"telephone_number": "602-298-7200",
"fax_number": "602-298-7202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "BYRON",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-27",
"last_updated": "2008-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901018657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.