Justin Olsen, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

33515 Issued in TX

Practice address

15600 San Pedro Ave Ste 107
San Antonio, TX 78232-3738

Phone

(435) 512-3442

NPI assigned

Sep 14, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Justin Olsen DDS PLLC.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • San Antonio, TX
  • NPI 1790668713
  NPD Authorized official
• Texas Dental Specialist Practice, PLLC

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1770225658
  NPD (past)

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1144570367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 SAN PEDRO AVE STE 107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323738",
            "telephone_number": "435-512-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 SAN PEDRO AVE STE 107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323738",
            "telephone_number": "435-512-3442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-0332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Hill Country Dr Ste 6",
            "address_purpose": "LOCATION",
            "city": "Kerrville",
            "state": "TX",
            "postal_code": "780285965",
            "country_code": "US",
            "telephone_number": "830-896-0056",
            "fax_number": "830-896-0039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1202 W Bitters Rd Bldg 6",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782167852",
            "country_code": "US",
            "telephone_number": "210-491-0015",
            "fax_number": "210-491-0352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-14",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "33515",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413760",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian L Olmos, MSW
• Marilou Sevilla Olohoy
• Oluwasegun Olomojobi, PT
• Janice Ann Olsen, CNM
• Jerry George Olsen, M.D.
• Marc Olsen
• Stacy L Olsen, SLP-A
• Olson Speech and Language P.C.
• Alexys Kathrine Olson, MSN, RN
• Brian M Olson, PSY.D.

• Oral and Maxillofacial Surgery (Dentist) in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.