Individual provider Active NPI

James G. Olsen, DDS

  • General Practice Dentistry
  • Ann Arbor, MI
National Provider Identifier
1174526131
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15057 Issued in MI
Practice address
3400 Travis Pointe Rd
Ste G
Ann Arbor, MI 48108-9620
Phone
(734) 996-0200
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15057 MI Primary

Addresses

Primary practice location

3400 Travis Pointe Rd
Ste G
Ann Arbor, MI 48108-9620

Mailing address

3400 Travis Pointe Rd
Ste G
Ann Arbor, MI 48108-9620
Phone (734) 996-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160420002223 MI Order and Referring Only - DentistPractitioner - Dentist 2163720384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15057MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174526131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 TRAVIS POINTE RD",
            "address_2": "STE G",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481089620",
            "telephone_number": "734-996-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 TRAVIS POINTE RD",
            "address_2": "STE G",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481089620",
            "telephone_number": "734-996-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "JAMES",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "15057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.