Active NPI
Ronald Robert Larsen, DDS
- Prosthodontics
- Sacramento, CA
National Provider Identifier
1811241664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 33487
- Practice address
- 1870 Avondale Ave
Suite 5
Sacramento, CA 95825-1388 - Phone
- (916) 484-0000
- Fax
- (916) 487-8644
- NPI assigned
- Nov 1, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 33487 | CA | Primary |
Addresses
Primary practice location
1870 Avondale Ave
Suite 5
Sacramento, CA 95825-1388
Mailing address
1870 Avondale Avenue
Suite 5
Sacramento, CA 95825
Phone (916) 484-0000
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351728000000",
"number": "1811241664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1870 AVONDALE AVENUE",
"address_2": "SUITE 5",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95825",
"telephone_number": "916-484-0000",
"fax_number": "916-487-8644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1870 AVONDALE AVE",
"address_2": "SUITE 5",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958251388",
"telephone_number": "916-484-0000",
"fax_number": "916-487-8644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "RONALD",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-11-01",
"last_updated": "2012-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "33487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.