Active NPI
Gary Andrew Olen, D.D.S., M.S
- Pediatric Dentistry
- El Cajon, CA
National Provider Identifier
1043303993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 24491
- Practice address
- 773 Broadway
El Cajon, CA 92021-4631 - Phone
- (619) 440-5915
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 24491 | CA | Primary |
Addresses
Primary practice location
773 Broadway
El Cajon, CA 92021-4631
Mailing address
773 Broadway
El Cajon, CA 92021-4631
Phone (619) 440-5915
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24491 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Olen and Maurer Pediatric Dentistry | Pediatric Dentistry | Past | Accepting new patients |
| Michael Maurer DDS Inc | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- El Cajon, CA
- NPI 1760155147
-
- Pediatric Dentistry
- El Cajon, CA
- NPI 1578032439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043303993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "773 BROADWAY",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920214631",
"telephone_number": "619-440-5915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "773 BROADWAY",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920214631",
"telephone_number": "619-440-5915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLEN",
"first_name": "GARY",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "D.D.S., M.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "24491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.