Active NPI
Thomas Obert Olson, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Hanover, PA
National Provider Identifier
1144540568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DS038290
- Practice address
- 250 Fame Ave
Suite 206
Hanover, PA 17331-1587 - Phone
- (717) 637-0202
- Fax
- (717) 637-5855
- NPI assigned
- Jun 8, 2010
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DS038290 | PA | Primary |
Addresses
Primary practice location
250 Fame Ave
Suite 206
Hanover, PA 17331-1587
Mailing address
250 Fame Ave
Suite 206
Hanover, PA 17331-1587
Phone (717) 637-0202
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1024778140001 | Medicaid | PA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS038290 | PA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388102400000",
"number": "1144540568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 FAME AVE",
"address_2": "SUITE 206",
"city": "HANOVER",
"state": "PA",
"postal_code": "173311587",
"telephone_number": "717-637-0202",
"fax_number": "717-637-5855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 FAME AVE",
"address_2": "SUITE 206",
"city": "HANOVER",
"state": "PA",
"postal_code": "173311587",
"telephone_number": "717-637-0202",
"fax_number": "717-637-5855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "THOMAS",
"middle_name": "OBERT",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-08",
"last_updated": "2013-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "PA",
"license": "DS038290",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1024778140001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hanover, PA
- Ryan Oberholtzer
- Emeka Obiriibe, PHARMD
- Obstetric & Gynecologic Associates of Hanover, Inc.
- Adewale Ayodeji Oladapo, PHAR.D
- Old Post Wellness, LLC
- Open Arms Recovery Center
- Alexandra Michele Orem, LMSW
- Oscar F Murillo, MD, LLC
- Peter Brian Oscsodal, PH.D., NCC, LPC
- Oss Orthopaedic Hospital, LLC (OSS Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.