Cyrus Michael Larson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9630 Issued in MT

Practice address

628 South Ave W
Suite B
Missoula, MT 59801-8020

Phone

(801) 310-7039

NPI assigned

Nov 4, 2010

Last updated

Nov 10, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Granite County Hospital District

  • Critical Access Hospital
  • Philipsburg, MT
  • NPI 1922073907
  Medicare reassignment NPD
• Meadowlark Dental Care PLLC

  • Dentist
  • Missoula, MT
  • NPI 1841648227
  NPD (past) Authorized official
• Granite County Hospital District

  • Rural Health Clinic/Center
  • Drummond, MT
  • NPI 1942321120
  NPD

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1891096079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 SOUTH AVE W",
            "address_2": "SUITE B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018020",
            "telephone_number": "801-310-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 SOUTH AVE W",
            "address_2": "SUITE B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018020",
            "telephone_number": "801-310-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "CYRUS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-04",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "9630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Larose
• Daniel Larsen, OD
• Eric Paul Larsen, D.O.
• Nevin Emily Larsen, DPT
• Beau Larson
• Jennifer Larson, ARNP
• Kelli Downs Larson, LCPC
• Lindsay Larson, FNP
• Tawna Larie Larson, LCSW
• James Laskin, PT, PHD

• General Practice Dentistry in Missoula, MT
• Providers in Missoula, MT by specialty
• General Practice Dentistry in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.