Active NPI
Cheryl Larsen, RDH
- Dental Hygienist
- Superior, WI
National Provider Identifier
1891194536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 10460
- Practice address
- 3600 Tower Ave
Superior, WI 54880-5589 - Phone
- (715) 394-5411
- Fax
- (715) 392-5086
- NPI assigned
- Aug 19, 2014
- 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 | 10460 | WI | Primary |
Addresses
Primary practice location
3600 Tower Ave
Superior, WI 54880-5589
Mailing address
4325 Grand Ave
Duluth, MN 55807-2730
Phone (218) 628-7035
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10460 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408406400000",
"number": "1891194536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4325 GRAND AVE",
"city": "DULUTH",
"state": "MN",
"postal_code": "558072730",
"telephone_number": "218-628-7035",
"fax_number": "218-722-6239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 TOWER AVE",
"city": "SUPERIOR",
"state": "WI",
"postal_code": "548805589",
"telephone_number": "715-394-5411",
"fax_number": "715-392-5086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "CHERYL",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-19",
"last_updated": "2014-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "10460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Superior, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.