Active NPI
Bryan T Larsen, DDS
- Dentist
- Manhattan, KS
National Provider Identifier
1922583210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61393
- Practice address
- 1305 Westloop PL
Manhattan, KS 66502-2841 - Phone
- (785) 539-5949
- Fax
- (785) 539-2717
- NPI assigned
- Oct 2, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 61393 | NE | |
| Dentist | 122300000X | 61393 | KS | Primary |
Addresses
Primary practice location
1305 Westloop PL
Manhattan, KS 66502-2841
Mailing address
1305 Westloop PL
Manhattan, KS 66502-2841
Phone (785) 539-5949
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 |
|---|---|---|---|
| 61393 | KS | MD | Dentist |
| 61393 | NE | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hungerford Witcher Walker and Snowden Dentistry Partnership | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Manhattan, KS
- NPI 1124138656
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664928000000",
"number": "1922583210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 WESTLOOP PL",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665022841",
"telephone_number": "785-539-5949",
"fax_number": "785-539-2717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 WESTLOOP PL",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665022841",
"telephone_number": "785-539-5949",
"fax_number": "785-539-2717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "BRYAN",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-02",
"last_updated": "2022-10-05",
"certification_date": "2022-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "61393",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KS",
"license": "61393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhattan, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.