Larson Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LARSON DENTAL LLC

Practice address

1632 Washington St NE
Minneapolis, MN 55413-1336

Phone

(612) 789-2853

NPI assigned

Aug 22, 2022

Last updated

Aug 22, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cory J Larson, DDSNPI 1487762548

Title

Owner

Phone

(612) 789-2853

Specialties & licenses 2

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cory John Larson, DDS

  • General Practice Dentistry
  • Minneapolis, MN
  • NPI 1487762548
  Authorized official Same address or phone
• Devon Halberg, DDS

  • Dentist
  • Minneapolis, MN
  • NPI 1194044842
  NPD (past)

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1922726280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 WASHINGTON ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131336",
            "telephone_number": "612-789-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 WASHINGTON ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131336",
            "telephone_number": "612-789-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARSON DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-789-2853",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori J Larsen, CRNA
• Megan Elizabeth Larsen
• Nicole Anne Larsen
• Sangeetha Larsen, PA-C
• Sean Larsen, MD
• Jamie Larson Jones, R.D., M.S., L.P.C.C.
• Catherine Margaret Larson-Nath, M.D.
• Abby Noel Larson
• Alan Larson, OD
• Alex Peter Larson, PHARMD

• Dentist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.