Active NPI
Dennis Palmer Olson, DDS
- Dentist
- Peoria, AZ
National Provider Identifier
1134333271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1564
- Practice address
- 13360 N 94TH Dr
Ste a
Peoria, AZ 85381 - Phone
- (623) 933-0777
- Fax
- (623) 933-1464
- NPI assigned
- May 9, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 1564 | AZ | Primary |
Addresses
Primary practice location
13360 N 94TH Dr
Ste a
Peoria, AZ 85381
Mailing address
5220 W Potter Drive
Glendale, AZ 85308
Phone (623) 322-8532
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ideal Dentistry, LTD | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Peoria, AZ
- NPI 1902920325
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1134333271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5220 W POTTER DRIVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85308",
"telephone_number": "623-322-8532",
"fax_number": "623-933-1464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13360 N 94TH DR",
"address_2": "STE A",
"city": "PEORIA",
"state": "AZ",
"postal_code": "85381",
"telephone_number": "623-933-0777",
"fax_number": "623-933-1464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "DENNIS",
"middle_name": "PALMER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "1564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
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.