Bradley Olsen, CDT

Primary specialty

Dental TherapistTaxonomy code 125J00000X

License

DT150 Issued in MN

Practice address

717 S State St Ste 2
Fairmont, MN 56031-4469

Phone

(507) 235-5985

NPI assigned

Jun 21, 2022

Sex

Male

Sole proprietor

No

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Christopher L. Olsen, DDS PLLC

  • Dental Clinic/Center
  • Fairmont, MN
  • NPI 1194106823
  NPD (past)

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1225769227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 S STATE ST STE 2",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469",
            "telephone_number": "507-235-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S STATE ST STE 2",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469",
            "telephone_number": "507-235-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "BRADLEY",
        "credential": "CDT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "MN",
            "license": "DT150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Nestegard, PHARMD
• New Directions Healing Center LLC
• Erik S Nitchie, LICSW
• Elizabeth Ann Odom, LPCC
• Richard Odom
• Okechukwu Ndubuisi Osuebi, MD
• Shawn Michael Overgaard, CRNA
• Emily Kay Ovrebo, PSY.D., LP
• Amy M Paradis, PHARMD
• Kaci Lei Paradis, CNP

• Dental Therapist in Fairmont, MN
• Providers in Fairmont, MN by specialty
• Dental Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.