Gregory G. Olsen, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

59360 Issued in CA

Practice address

2370 E Bidwell
Suite 130
Folsom, CA 95630-3463

Phone

(916) 983-6637

Fax

(916) 983-6610

NPI assigned

Jun 8, 2010

Sex

Male

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Mar 14, 2016 through Mar 14, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1205156775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 E BIDWELL",
            "address_2": "SUITE 130",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303463",
            "telephone_number": "916-983-6637",
            "fax_number": "916-983-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 E BIDWELL",
            "address_2": "SUITE 130",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303463",
            "telephone_number": "916-983-6637",
            "fax_number": "916-983-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "GREGORY",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019127270",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "59360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Patrick Oliaro, DO
• Oleg Oliferuk, D.D.S.
• Mandi Michele Oliphant, M.A.
• Ben Joseph Olivo, PT
• Dennis Edward Olsen II, LMFT
• Marty Olsen, IBCLC
• Theresia Ananda Onyango
• Optimal Wellness Clinic Inc
• Philip Jacob Orisek, M.D.
• Kirstyn Ormsby, DPT

• Oral and Maxillofacial Surgery (Dentist) in Folsom, CA
• Providers in Folsom, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.