Phillip Peter Olsen, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

6552335-8903 Issued in UT

Practice address

625 E 500 S
Suite 202
Bountiful, UT 84010-3882

Phone

(801) 292-4141

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382659200000",
    "number": "1063554434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E 500 S",
            "address_2": "SUITE 202",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840103882",
            "telephone_number": "801-292-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E 500 S",
            "address_2": "SUITE 202",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840103882",
            "telephone_number": "801-292-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "PHILLIP",
        "middle_name": "PETER",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2013-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "6552335-8903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Oliver, GNP
• Jessalyn Ollerton
• Brady J Olsen, DMD
• Candland Lee Olsen, DDS
• Matthew James Olsen, DMD
• Wayne Merlin Olsen, D.C.
• Gregory G. Oman, DDS
• Eveline Rita Onkels, DC
• Michael J Onkels, D.C
• Optimal Family Medicine, PLLC

• Dentist in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; 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.