Healthcare Provider Details

I. General information

NPI: 1407378342
Provider Name (Legal Business Name): YARBROUGH & LARKIN ORTHODONTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 07/21/2022
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 SUNSET POINT RD STE B
CLEARWATER FL
33765-1516
US

IV. Provider business mailing address

2450 SUNSET POINT RD STE B
CLEARWATER FL
33765-1516
US

V. Phone/Fax

Practice location:
  • Phone: 727-797-5460
  • Fax: 813-333-7323
Mailing address:
  • Phone: 727-797-5460
  • Fax: 813-333-7323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN18445
License Number StateFL

VIII. Authorized Official

Name: RONALD YARBROUGH
Title or Position: ORTHODOTIST
Credential: D.M.D
Phone: 813-385-2844