Robert L Larison, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

Practice address

1214 S 4TH St
Springfield, IL 62703-2229

Phone

(217) 528-1502

Fax

(217) 528-7448

NPI assigned

Apr 19, 2007

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

Enrolled in IL

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

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 and National Provider Directory roles.

• Dr Robert L Larison PC

  • Dentist
  • Springfield, IL
  • NPI 1447477849
  NPD (past) Authorized official

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720205115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 S 4TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032229",
            "telephone_number": "217-528-1502",
            "fax_number": "217-528-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 S 4TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032229",
            "telephone_number": "217-528-1502",
            "fax_number": "217-528-7448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARISON",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Louise Lansing, ACNP
• Carol J Lantz, APN
• Victor J Lanzotti, MD
• Valerie Pearl Lapsansky-Frizzo, COTA
• Laquita Wellness & Care Palace LLC
• Kelly Larosa, LCSW
• Ann R Larson, CRNA
• Breanne L Larson, FNP-BC
• Michael R. Larson
• Rebecca J Larson, MD

• Dentist in Springfield, IL
• Providers in Springfield, IL by specialty
• Dentist in Illinois

• 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.
• 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.