DR. MICHAEL ANDREW LARSEN D.D.S. NPI 1376570242

NPI Information

  • NPI: 1376570242
  • Provider Name: DR. MICHAEL ANDREW LARSEN, D.D.S.
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1361 E 16TH ST
    BURLEY, ID
    ZIP 83318
  • Phone: (208) 677-5198

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NPI Details

DR. Michael Andrew Larsen, D.D.S. is a general practice dentist in Burley, ID. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Michael Andrew Larsen, D.D.S. NPI is 1376570242. 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:

1361 E 16TH ST
BURLEY, ID
ZIP 83318-008
Phone: (208) 677-5198
Fax: (208) 678-2245

The NPI 1376570242 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 6/27/2006 and was last updated on 11/27/2012.

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
1122300000XDentistDE10258WASHINGTONNo
21223G0001XDentistGeneral PracticeD-3993IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15050232MEDICAIDWASHINGTON
2807518200MEDICAIDIDAHO

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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