DR. IVAN M LARSEN D.M.D NPI 1285185355

NPI Information

  • NPI: 1285185355
  • Provider Name: DR. IVAN M LARSEN, D.M.D
  • Classification: Dentist - 1223E0200X
  • Specialization: Endodontics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1002 DIAMOND RDG STE 1500
    JEFFERSON CITY, MO
    ZIP 65109
  • Phone: (573) 298-4400

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NPI Details

DR. Ivan M Larsen, D.M.D is an endodontics dentist in Jefferson City, MO. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. DR. Ivan M Larsen, D.M.D NPI is 1285185355. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1002 DIAMOND RDG STE 1500
JEFFERSON CITY, MO
ZIP 65109-914
Phone: (573) 298-4400

The NPI 1285185355 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 10/24/2016 and was last updated on 9/28/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentistD-4797IDAHONo
2122300000XDentist2019008323MISSOURINo
31223E0200XDentistEndodontics2019008323MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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