Olga Michaud, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

22DI02358500 Issued in NJ

Practice address

301 Bridge PLZ N
Fort Lee, NJ 07024-5059

Phone

(201) 346-4660

Fax

(201) 346-1116

NPI assigned

Dec 5, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1003098724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 ANDREA CT",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525346",
            "telephone_number": "201-845-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BRIDGE PLZ N",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245059",
            "telephone_number": "201-346-4660",
            "fax_number": "201-346-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAUD",
        "first_name": "OLGA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI02358500",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "051096",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.