Active NPI
Edwin Joseph Olsen, DDS
- General Practice Dentistry
- Hardwick, VT
National Provider Identifier
1184880809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0160000641
- Practice address
- 151 North Main Street
Hardwick, VT 05843-0537 - Phone
- (802) 472-2260
- Fax
- (802) 472-2263
- NPI assigned
- Aug 1, 2008
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0160000641 | VT | Primary |
Addresses
Primary practice location
151 North Main Street
Hardwick, VT 05843-0537
Mailing address
151 North Main Street
Hardwick, VT 05843-0537
Phone (802) 472-2260
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001913 | Medicaid | VT |
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 |
|---|---|---|---|
| 0160000641 | VT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328832000000",
"number": "1184880809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 NORTH MAIN STREET",
"city": "HARDWICK",
"state": "VT",
"postal_code": "058430537",
"telephone_number": "802-472-2260",
"fax_number": "802-472-2263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 NORTH MAIN STREET",
"city": "HARDWICK",
"state": "VT",
"postal_code": "058430537",
"telephone_number": "802-472-2260",
"fax_number": "802-472-2263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSEN",
"first_name": "EDWIN",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-01",
"last_updated": "2012-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VT",
"license": "0160000641",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0001913",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hardwick, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.