Nathan Larson

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D011458 Issued in AZ

Practice address

1717 E Queen Creek Rd
Gilbert, AZ 85298

Phone

(623) 400-3234

NPI assigned

Mar 14, 2012

Last updated

May 8, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1760757371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 E MELROSE ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977521",
            "telephone_number": "480-848-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 E QUEEN CREEK RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85298",
            "telephone_number": "623-400-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-14",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011458",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "8362005-9921",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "D011458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Craig Larsen, DDS
• David M Larson, MD
• Emmalee Larson, OTR/L
• Ethan James Larson, D.M.D. M.S.
• Julia Larson
• Tara Lynn Larson, MS OTR/L
• Zenda P Lasao, PA-C
• Matthew Lasinis
• Jenna Laskoski, PA-C
• Chantelle Lassak, PA-C

• Orthodontics and Dentofacial Orthopedics Dentistry in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; 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.