Individual provider Active NPI

Mel Herbert Olafsen, D.D.S.

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1386805141
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36814 Issued in CA
Practice address
3444 Kearny Villa Rd
Suite 406
San Diego, CA 92123-1959
Phone
(858) 278-4500
Fax
(858) 278-5071
NPI assigned
Jun 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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 36814 CA Primary

Addresses

Primary practice location

3444 Kearny Villa Rd
Suite 406
San Diego, CA 92123-1959

Mailing address

3444 Kearny Villa Rd
Suite 406
San Diego, CA 92123-1959
Phone (858) 278-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
36814CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1386805141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3444 KEARNY VILLA RD",
            "address_2": "SUITE 406",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231959",
            "telephone_number": "858-278-4500",
            "fax_number": "858-278-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3444 KEARNY VILLA RD",
            "address_2": "SUITE 406",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231959",
            "telephone_number": "858-278-4500",
            "fax_number": "858-278-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAFSEN",
        "first_name": "MEL",
        "middle_name": "HERBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.