Jason C Olsen, D.D.S., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2159 Issued in MT

Practice address

715 W Central Ave
Missoula, MT 59801-6808

Phone

(406) 728-2840

Fax

(406) 728-3083

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 30, 2016 through Mar 30, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073673190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 W CENTRAL AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016808",
            "telephone_number": "406-728-2840",
            "fax_number": "406-728-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W CENTRAL AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016808",
            "telephone_number": "406-728-2840",
            "fax_number": "406-728-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "JASON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP",
            "identifier": "5512754",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "41244",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0113305",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lily Oligee, RBT
• Neva McKinnon Oliver, APRN
• Olsen Dental PC (Olsen and Peters Dental Group)
• Diane Olsen, PCLC
• George Martin Olsen, DDS
• Tessa Marie Olsen
• Barry Arthur Olson, PHYSICAL THERAPY
• Bernard Olson IV, DC
• Byron Chapman Olson, MD
• Erica C Olson, MD

• General Practice Dentistry in Missoula, MT
• Providers in Missoula, MT by specialty
• General Practice Dentistry in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.