NPIMap

Organization Active NPI

Marshall Olson DDS PLLC

  • Dentist
  • Keller, TX
National Provider Identifier
1306284609
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
23256 Issued in TX
Legal business name
MARSHALL OLSON DDS PLLC
Practice address
777 Bandit TRL
Suite a
Keller, TX 76248-0111
Phone
(817) 427-2622
Fax
(817) 427-2625
NPI assigned
Jun 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Authorized official

Name
Dr. Marshall Olson, DDSNPI 1851594386
Title
Owner/Dentist
Phone
(817) 427-2622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 23256 TX Primary

Addresses

Primary practice location

777 Bandit TRL
Suite a
Keller, TX 76248-0111

Mailing address

777 Bandit TRL
Suite a
Keller, TX 76248-0111
Phone (817) 427-2622

Other names 1

  • Boca Sana Dental Doing business as

National Provider Directory

National Provider Directory

Locations

777 Bandit Trl
Ste A
Keller, TX 76248
Phone (817) 427-2622

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388448000000",
    "number": "1306284609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANDIT TRL",
            "address_2": "SUITE A",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762480111",
            "telephone_number": "817-427-2622",
            "fax_number": "817-427-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANDIT TRL",
            "address_2": "SUITE A",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762480111",
            "telephone_number": "817-427-2622",
            "fax_number": "817-427-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL OLSON DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-12-31",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "817-427-2622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "23256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boca Sana Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; 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.