Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

KG1 PLLC

Organization General Practice Dentistry · NPI 1265308753

KG1 PLLC is a General Practice Dentistry in Phoenix, Arizona. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10 W Adams St
Phoenix, AZ 85003-2025
Phone: (602) 777-5178
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1265308753
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Clark Larson — Owner · (480) 310-7721
NPI enumeratedOctober 13, 2025
Last updated in NPPESOctober 13, 2025
Certification dateOctober 13, 2025
Mailing address10 W Adams St, Phoenix, AZ 85003-2025

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