DR. LARISSA W HANSON (NPI# 1013320142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013320142 |
| Entity Type | Individual |
| Full Name | DR. LARISSA W HANSON |
| Credential | D.M.D. |
| Practice Address |
3777 S Ridgewood Ave Port Orange FL 32129-3528 |
| Mailing Address |
2937 S Atlantic Ave Apt 1805 Daytona Beach Shores FL 32118-6048 |
| Practice Telephone | 3867601200 |
| Mailing Telephone | 3867601200 |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-07-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN20640 | FL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356987218 | Larissa Hanson | Massage Therapist | 56880 Venture Ln, Bend, OR 97707-2158 | 2019-11-25 |
| Street Address |
3777 S RIDGEWOOD AVE |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32129-3528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912171463 | James Edward Montgomery | Dentist | 3777 S Ridgewood Ave, Port Orange, FL 32129-3528 | 2008-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
| 1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
| 1679892996 | Pamela Kirby Pa | Clinic/Center | 4606 South Clyde Morris Boulevard, Suite 1j, Port Orange, FL 32129 | 2010-05-26 |
| 1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
| 1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
| Find all providers in zip 32129 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568955375 | Nicole Hovencamp | Dentist | 4904 Clyde Morris Blvd, Port Orange, FL 32129-4170 | 2018-06-07 |
| 1487179503 | Amandeep Singh Chadda | Dentist | 790 Dunlawton Ave Ste F, Port Orange, FL 32127-4222 | 2017-08-09 |
| 1376915132 | Comfortable Care Dental Health Professionals, Pa | Dentist | 5445 S. Williamson Blvd, Port Orange, FL 32128 | 2015-10-20 |
| 1700203528 | Pimendent II, Pa | Dentist | 1812 Dunlawton Ave Ste 101, Port Orange, FL 32127-2925 | 2014-03-19 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1427258631 | George A. M. Sonbol | Dentist | 4003 S Nova Rd, Port Orange, FL 32127-4922 | 2007-07-25 |
| 1366655466 | Carl Martin Honerlaw | Dentist | 3943 S Nova Rd, Port Orange, FL 32127-4910 | 2007-05-07 |
| 1720138233 | Cathleen Huong Diem Luong | Dentist | 5820 S Williamson Blvd, Suite #1, Port Orange, FL 32128-6400 | 2007-01-10 |
| 1952314411 | Scott Thomas Messick | Dentist | 840 Dunlawton Ave Ste C, Port Orange, FL 32127-4224 | 2006-08-15 |
| 1164442695 | I Warren Hersch | Dentist | 823 Dunlawton Ave, Suite E, Port Orange, FL 32127-4220 | 2006-07-20 |
| Find all providers in PORT ORANGE | ||||
| City | PORT ORANGE |
| Zip Code | 32129 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.