Earl R. Larson, D.D.S., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13769 Issued in MO

Legal business name

EARL R. LARSON, D.D.S., P.C.

Doing business as

Wildhorse Dental

Practice address

150 Long Road Ste 100
Chesterfield, MO 63005

Phone

(636) 537-0447

Fax

(636) 537-9452

NPI assigned

Jan 22, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Earl Robert Larson, DDSNPI 1831110253

Title

President

Phone

(636) 537-0447

Specialties & licenses 1

Addresses

Other names 1

• Wildhorse Dental Doing business as

Locations

Practitioners 1

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.

• Earl R Larson, D.D.S.

  • Dentist
  • Lakewood Ranch, FL
  • NPI 1831110253
  NPD (past) Authorized official

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516752000000",
    "number": "1992036495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 LONG ROAD STE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63005",
            "telephone_number": "636-537-0447",
            "fax_number": "636-537-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 LONG ROAD STE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63005",
            "telephone_number": "636-537-0447",
            "fax_number": "636-537-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARL R. LARSON, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-22",
        "last_updated": "2018-01-24",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-537-0447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "13769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wildhorse Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Durnin
• Amy Marie Durso, MSN, RN, FNP-C
• Stephanie Joy Dusek, NP
• Shae Dwyer, DC
• Ear Nose Throat Medical Service
• John Easterling, MAC
• Russell Hugh Eaves, PT
• Edgerley Dental LLC (Chesterfield Woodlake Dental and Prosthodontics)
• Paul Douglas Edgerley, D.D.S., MDS
• Kristin Leslie Edmonds, MM MA CCC-SLP

• General Practice Dentistry in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.