Chad Evans Larson, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

13231 Issued in MN

Practice address

1705 Broadway Ave S Ste a
Rochester, MN 55904-7973

Phone

(507) 288-4427

Fax

(507) 288-8497

NPI assigned

Jul 30, 2013

Last updated

May 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• GLK Orthodontics PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Rochester, MN
  • NPI 1891829669
  NPD

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1609208826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 BROADWAY AVE S STE A",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559047973",
            "telephone_number": "507-288-4427",
            "fax_number": "507-288-8497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 BROADWAY AVE S STE A",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559047973",
            "telephone_number": "507-288-4427",
            "fax_number": "507-288-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "CHAD",
        "middle_name": "EVANS",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "13231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karyn Larson Smith
• Angela L Larson, PA-C
• Annalise N Larson, M.D..
• Caitlin Larson, OTR
• Casey Marie Larson, LICSW
• Christian Larson
• Daniel Philip Larson, MD
• David E Larson, M.D.
• David W Larson, M.D.
• Ellen Lucy Larson, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Rochester, MN
• Providers in Rochester, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.