Individual provider Active NPI

Stephen James Larson, D.M.D., M.S.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mountain View, CA
National Provider Identifier
1699883876
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
32115 Issued in CA
Practice address
777 Cuesta Dr Ste 100
Mountain View, CA 94040-3765
Phone
(650) 969-0672
Fax
(650) 969-1067
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 32115 CA Primary

Addresses

Primary practice location

777 Cuesta Dr Ste 100
Mountain View, CA 94040-3765

Mailing address

777 Cuesta Dr Ste 100
Mountain View, CA 94040-3765
Phone (650) 969-0672

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

LicenseStateTypeSpecialty
32115CAMDGeneral Care Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699883876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CUESTA DR STE 100",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940403765",
            "telephone_number": "650-969-0672",
            "fax_number": "650-969-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CUESTA DR STE 100",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940403765",
            "telephone_number": "650-969-0672",
            "fax_number": "650-969-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "STEPHEN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "32115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

  • 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.