Olysia N Takla, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D009180 Issued in AZ

Practice address

5855 W Utopia Rd
Glendale, AZ 85308-5251

Phone

(623) 806-7175

NPI assigned

Aug 11, 2014

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

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 May 26, 2021 through May 26, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: otakla18641@direct.midwestern.edu

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.

• Keith Cooper DDS CP Ficoi PLLC

  • Dentist
  • Scottsdale, AZ
  • NPI 1770464679
  NPD
• Midwestern University

  • Dental Clinic/Center
  • Glendale, AZ
  • NPI 1164744009
  NPD

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1124437553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5813 W DEL LAGO CIR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086205",
            "telephone_number": "440-822-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 W UTOPIA RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085251",
            "telephone_number": "623-806-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKLA",
        "first_name": "OLYSIA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arlene Tagalicud-Benitez, D.D.S.
• Rachel Tague, RDH
• Tailored 2 U Psychiatry, PLLC
• Jessica Lynn Taintor, PT, DPT
• Taking Root Counseling LLC
• Angelita Maria Talamantes, OTR/L
• Ruchi Talanki, RDN
• Mireya Talavera, PHARM D.
• Talk It Out Therapy LLC
• Amanda Tallman

• General Practice Dentistry in Glendale, AZ
• Providers in Glendale, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.