Michelle Renee Olmstead, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25103/DE00008465 Issued in WA

Practice address

2207 N Molter Rd
Suite 200
Liberty Lake, WA 99019-7570

Phone

(509) 891-5001

Fax

(509) 891-2787

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Liberty Lake Family Dentistry

  • General Practice Dentistry
  • Liberty Lake, WA
  • NPI 1255658886
  NPD (past) Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063523165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 N MOLTER RD",
            "address_2": "SUITE 200",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990197570",
            "telephone_number": "509-891-5001",
            "fax_number": "509-891-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 N MOLTER RD",
            "address_2": "SUITE 200",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990197570",
            "telephone_number": "509-891-5001",
            "fax_number": "509-891-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMSTEAD",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "25103/DE00008465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5032438",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NRS Arizona, PA
• Oak & Ember Counseling LLC
• Andrew Odle, M.D.
• Michael John Odonnell, R.PH.
• Odyssey Healthcare Operating B, LP
• Orebaugh Enterprises LLC
• Pamela Orebaugh
• Osborne Chiropractic PLLC
• Daniel J Osborne, DC
• Rebecca L Pagotelis, PT

• General Practice Dentistry in Liberty Lake, WA
• Providers in Liberty Lake, WA by specialty
• General Practice Dentistry in Washington

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.