Active NPI
Alisha Marie Larson, RDH BS
- Dental Hygienist
- Fort Washakie, WY
National Provider Identifier
1780842526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 747
- Practice address
- 29 Black Coal Drive
Fort Washakie, WY 82514 - Phone
- (307) 332-3527
- NPI assigned
- May 29, 2008
- Last updated
- May 29, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 747 | WY | Primary |
Addresses
Primary practice location
29 Black Coal Drive
Fort Washakie, WY 82514
Mailing address
1210 McDougall Dr
Lander, WY 82520-3531
Phone (307) 335-5960
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 747 | WY | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212019200000",
"number": "1780842526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 MCDOUGALL DR",
"city": "LANDER",
"state": "WY",
"postal_code": "825203531",
"telephone_number": "307-335-5960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BLACK COAL DRIVE",
"city": "FORT WASHAKIE",
"state": "WY",
"postal_code": "82514",
"telephone_number": "307-332-3527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "ALISHA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "RDH BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-29",
"last_updated": "2008-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WY",
"license": "747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Washakie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.