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Deactivated NPI 1740262401 Deactivated / Inactive NPI Male Practitioner

Dr. Keith Rodney Larson , DMD

Dentist - General Practice • Beaverton, OR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Keith Larson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 17, 2005
NPI Deactivation Date October 30, 2025
Total Practice Duration ~20 Years of Practice (2005 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Keith Larson, DMD was a registered Dentist - General Practice practicing in Beaverton, OR. Throughout an active medical career spanning 20 years, Dr. Larson provided care at the practice location at 17895 NW EVERGREEN PKWY until profile deactivation on 2025-10-30.

Practice Location & Contact Primary Location

Practice Address

17895 Nw Evergreen Pkwy

Beaverton, OR 970067402

Telephone 5035339868
Fax 5035339508
Associated Practice Facility / Clinic
🏢 Daniel & Esther Lee, Dds, Pc Facility NPI 1972878221

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Beaverton, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
91 Specialists

Practicing in Beaverton, OR (1994 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OR 4338

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Dr. Daniel Lee , DDS

Dentist - General Practice

NPI 1184787178

Doctor of Dental Surgery

Tete Mensah , RDH

Dental Hygienist

NPI 1447708581

Registered Dental Hygienist

Dr. Hyo Lee , DMD

Dentist - General Practice

NPI 1962694059

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 30, 2025

Record deactivated on October 30, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 17895 NW EVERGREEN PKWY, BEAVERTON, OR 970067402 (Tel: 5035339868)

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Updated Business Mailing Address July 08, 2007

Registered at 17895 NW EVERGREEN PKWY, BEAVERTON, OR 970067402 (Tel: 5035339868)

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Provider Name / Credentials Updated July 08, 2007

Recorded as KEITH LARSON, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #4338 in OR)

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Initial NPI Registration & Enumeration November 17, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1740262401
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 17, 2005
Last Update: July 08, 2007
Deactivation Date: October 30, 2025

Mailing Address

17895 Nw Evergreen Pkwy

Beaverton, OR 970067402

Phone: 5035339868

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.