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BRYCE ROBERT LARSEN D.M.D. NPI 1821210535


NPI Information

NPI: 1821210535
Provider Name: BRYCE ROBERT LARSEN, D.M.D.
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
950 HOSPITAL WAY
SUITE B
POCATELLO, ID
ZIP 83201
Phone: (208) 233-7007
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Bryce Robert Larsen, D.M.D. is a general practice dentist in Pocatello, 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. Bryce Robert Larsen, D.M.D. NPI is 1821210535. 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:

950 HOSPITAL WAY
SUITE B
POCATELLO, ID
ZIP 83201-789
Phone: (208) 233-7007
Fax: (208) 233-2512

The enumeration date for this NPI number is 5/3/2007 and was last updated on 7/8/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeD3894IDAHOYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18072105MEDICAIDIDAHO

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.