Mark R Olsen DDS PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MARK R OLSEN DDS PLLC

Doing business as

Sawtooth Kids Pediatric Dentistr
Sawtooth Kids Pediatric Dentistry

Practice address

10034 Jordan Lee St
Nampa, ID 83687

Phone

(208) 910-9000

NPI assigned

Aug 25, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Mark Olsen, DDSNPI 1780816652

Title

Dentist/Owner

Phone

(208) 910-9000

Specialties & licenses 1

Addresses

Other names 2

• Sawtooth Kids Pediatric Dentistr Doing business as
• Sawtooth Kids Pediatric Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Olsen, D.D.S.

  • Pediatric Dentistry
  • Star, ID
  • NPI 1780816652
  NPD Authorized official

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1215712666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 W LADLE RAPIDS ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467011",
            "telephone_number": "208-910-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10034 JORDAN LEE ST",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83687",
            "telephone_number": "208-910-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R OLSEN DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "208-910-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sawtooth Kids Pediatric Dentistr",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sawtooth Kids Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Larissa Mann, AU.D.
• Kelly B. Mansfield, D.D.S.
• Madison Mansfield, MD
• Lori Ann Manzanares, LPC
• Caroline Vieira Marino
• Mark S Chown Mdpa
• Kimberly Marker, LCPC
• Jennifer Erin Marschall
• Abigail Marshall
• Daniel Reed Marshall

• Pediatric Dentistry in Nampa, ID
• Providers in Nampa, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.