# DR. MICHAEL ANDREW LARSEN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1376570242
- **Gender:** Man
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE10258 | WA | — |
| 1223G0001X | General Practice Dentistry | D-3993 | ID | Yes |

## Other

- **Enumeration date:** 06/27/2006
- **Last updated:** 11/27/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5050232 | — | WA |
| 05 | — | 807518200 | — | ID |