Octavio Mario Oliva, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

33656 Issued in TX

Practice address

317 S Market St
Goliad, TX 77963-4167

Phone

(361) 645-2381

NPI assigned

Feb 22, 2018

Last updated

Apr 4, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amdg Dental PLLC

  dba Goliad Dental Care

  • Dental Clinic/Center
  • Goliad, TX
  • NPI 1376283010
  NPD Authorized official
• Goliad Dental Care

  • General Practice Dentistry
  • Goliad, TX
  • NPI 1003924267
  NPD (past)

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1194226332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 S MARKET ST",
            "city": "GOLIAD",
            "state": "TX",
            "postal_code": "779634167",
            "telephone_number": "205-527-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 S MARKET ST",
            "city": "GOLIAD",
            "state": "TX",
            "postal_code": "779634167",
            "telephone_number": "361-645-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVA",
        "first_name": "OCTAVIO",
        "middle_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-22",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La Bahia Nursing and Rehabilitation LP
• Jessica Rae Lambeck, SLP
• Lisa Ann Martinez, COTA
• Kongyan Drew Nicely, DDS
• Alex Nunez
• Brandi Ondrusek
• Jose Luis Ortiz, CCC/SLP
• Dylan Fanelli Riedesel, DPT
• Sahara Medical Consulting, PLLC (Goliad Health & Wellness)
• Jacqueline Denean Stehling, LVN

• General Practice Dentistry in Goliad, TX
• Providers in Goliad, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; 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.