Individual provider Active NPI

Richlund Dean Olson, DDS

  • General Practice Dentistry
  • Centennial, CO
National Provider Identifier
1245265933
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
105735 Issued in CO
Practice address
6930 S University Blvd
Suite 204
Centennial, CO 80122-1594
Phone
(303) 741-4600
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 105735 CO Primary

Addresses

Primary practice location

6930 S University Blvd
Suite 204
Centennial, CO 80122-1594

Mailing address

6930 S University Blvd.
Suite 204
Centennial, CO 80122-1598
Phone (303) 741-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150306001210 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6800112038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105735COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245265933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6930 S UNIVERSITY BLVD.",
            "address_2": "SUITE 204",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801221598",
            "telephone_number": "303-741-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6930 S UNIVERSITY BLVD",
            "address_2": "SUITE 204",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801221594",
            "telephone_number": "303-741-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "RICHLUND",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "105735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.