Steven J. Larsen, FAGD DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-1347 Issued in ID

Practice address

1088 N Skyline Dr
Idaho Falls, ID 83402-1726

Phone

(208) 524-0870

Fax

(208) 524-0873

NPI assigned

Mar 7, 2007

Last updated

Jul 8, 2007By 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

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.

• Parkwest Dental Care

  • Dental Clinic/Center
  • Idaho Falls, ID
  • NPI 1861666745
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649300609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088 N SKYLINE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834021726",
            "telephone_number": "208-524-0870",
            "fax_number": "208-524-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 N SKYLINE DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834021726",
            "telephone_number": "208-524-0870",
            "fax_number": "208-524-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "STEVEN",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "FAGD DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-1347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Lang, LCPC
• Linda Lanham
• Brandon Leon Larsen, PA-C
• Matthew F Larsen, DO
• Paul Lorenzo Larsen, PA-C
• Boyd Eric Larson, PA-C
• Brandy Lee Larson, FNP
• Gracie Larson
• Ryan Larson
• Tyler J. Larson, DPT

• General Practice Dentistry in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.