Larisa Takhalova, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

055646 Issued in NY

Practice address

6932 Fleet St
Forest Hills, NY 11375-5148

Phone

(718) 670-1060

NPI assigned

Apr 19, 2010

Sex

Female

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

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500076800000",
    "number": "1871819607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 WESTERN AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033512",
            "telephone_number": "518-512-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6932 FLEET ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755148",
            "telephone_number": "718-670-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKHALOVA",
        "first_name": "LARISA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2017-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "055646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2017; 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.