Susan Michelle Larsen in Mesa - Dentist
Susan Michelle Larsen - NPI 1114010188
Susan Michelle Larsen is a Dentist in Mesa, Arizona. Susan Michelle Larsen practices all healthcare services and medical treatments related to Dentist. The NPI Number for Susan Michelle Larsen is 1114010188. The last update date is 2007-07-09.
Susan Michelle Larsen's current location address is 1245 E Southern Ave, Mesa, Arizona. You can contact this provider via phone number 4806106544 and fax number 4806330670. The mailing address for Susan Michelle Larsen is 1245 E Southern Ave, Mesa, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Susan Michelle Larsen |
|---|---|
| Address | 1245 E Southern Ave, Mesa, Arizona |
| Phone Number | 4806106544 |
| Fax Number | 4806330670 |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1114010188 |
|---|---|
| Provider Enumeration Date | 2006-10-02 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 1245 E Southern Ave |
|---|---|
| City | Mesa |
| State | Arizona (AZ) |
| Post Code | 852045137 |
| Phone Number | 4806106544 |
| Fax Number | 4806330670 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | D5678 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 703323 | AZ | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Susan Michelle Larsen by the Centers for Medicare & Medicaid Services?
The Susan Michelle Larsen has been issued the NPI (National Provider Identifier) 1114010188, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Susan Michelle Larsen's facilities are geographically located?
The facilities of Susan Michelle Larsen are physically situated at the following location: 1245 E Southern Ave, Mesa, AZ, 852045137.
What is Susan Michelle Larsen's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Susan Michelle Larsen is Dentist, and the taxonomy code that categorizes this field of expertise is 122300000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1114010188 to Susan Michelle Larsen?
The Susan Michelle Larsen received its 1114010188 assignment from the Centers for Medicare & Medicaid Services on 2006-10-02.
When was the information pertaining to Susan Michelle Larsen most recently updated or revised?
The details related to Susan Michelle Larsen, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-09.