KG1 PLLC
NPI 1265308753
Dentist - General Practice in Phoenix, AZ

Q: What is Kg1 PLLC's NPI number?

The NPI number for Kg1 PLLC is 1265308753. It was assigned to this organization in the NPPES registry on October 13, 2025.

Q: What is Kg1 PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Kg1 PLLC was last updated on October 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 13, 2025

10 W ADAMS ST, PHOENIX, AZ 85003(602) 777-5178 Get Directions Write a Review

NPPES record last updated: October 13, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Kg1 Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KG1 PLLC (NPI 1265308753) is a healthcare organization registered as a general practice in Phoenix, Arizona and active in the NPI registry since October 2025. The organization lists Clark D Larson, Owner, as its authorized official.

NPPES Registry Identity

NPI1265308753

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameKG1 PLLC

Location Address10 W ADAMS STPhoenix, AZ 85003-2025

Mailing Address10 W Adams StPhoenix, AZ 85003-2025 · (602) 777-5178

Phone(602) 777-5178

Organization SubpartNo

Authorized OfficialClark D LarsonOwner · (480) 310-7721

Enumeration DateOctober 13, 2025

NPPES CertifiedOctober 13, 2025

✔ NPI 1265308753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

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.

10 W ADAMS ST, Phoenix, AZ 85003

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KEVIN MAMOOTTIL THOMAS

Dentist

10 W ADAMS ST
PHOENIX, AZ 85003

Maricopa County (602) 207-8528

THE SMYL CO

Dentist (Orthodontics and Dentofacial Orthopedics)

10 W ADAMS ST
PHOENIX, AZ 85003

Maricopa County (602) 362-2444

REBECCA WEBB

Dentist

10 W ADAMS ST
PHOENIX, AZ 85003

Maricopa County (602) 207-8528

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kg1 PLLC's NPI number?

The NPI number for Kg1 PLLC is 1265308753. It was assigned to this organization in the NPPES registry on October 13, 2025.

Where is Kg1 PLLC located?

Kg1 PLLC is located at 10 W Adams St, Phoenix, AZ 85003. The listed phone number is (602) 777-5178.

What is Kg1 PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Kg1 PLLC was last updated on October 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.