MEDICARE: DR. NATHAN JOHN LARKIN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN31324	FL

General Provider Information

NPI Number	:	1457140642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN JOHN LARKIN DMD

Provider Business Mailing Address
First Line	:	221 W HUBBARD ST UNIT 1410
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-4920
Country	:	US
Telephone Number	:	612-716-4360
Fax Number	:

Provider Business Practice Location Address
First Line	:	5670 FRUITVILLE RD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34232-6407
Country	:	US
Telephone Number	:	612-716-4360
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	03/12/2026

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