Michelle Claudette Olsen, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

41178 Issued in CA

Practice address

3351 El Camino Real
Ste. 222
Atherton, CA 94027

Phone

(650) 361-0180

Fax

(650) 361-0113

NPI assigned

Mar 26, 2007

Last updated

Nov 12, 2015By the provider in NPPES

Sex

Female

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

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.

Opted out of Medicare

Yes, effective Apr 4, 2016 through Apr 4, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Shih & Olsen GP

  dba Peninsula Endodontics Dental Group

  • Endodontics
  • Atherton, CA
  • NPI 1568597540
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1417074030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3351 EL CAMINO REAL",
            "address_2": "STE. 222",
            "city": "ATHERTON",
            "state": "CA",
            "postal_code": "94027",
            "telephone_number": "650-361-0180",
            "fax_number": "650-361-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 EL CAMINO REAL",
            "address_2": "STE. 222",
            "city": "ATHERTON",
            "state": "CA",
            "postal_code": "94027",
            "telephone_number": "650-361-0180",
            "fax_number": "650-361-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "MICHELLE",
        "middle_name": "CLAUDETTE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "41178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Umang Mehta, M.D.
• Seyed Babak Mostaan, DDS
• Nazila Doroodian DMD Inc
• Andrew B Newman, M.D.
• Katherine Wattiker Olivetti, LCSW
• Pacific Endoscopy LLC (Atherton Endoscopy Center)
• Pacific Endoscopy Services (Atherton Endoscopy Center)
• Lisa Riedle, PT
• Maria Esther Rivera, MD
• Cyrus S. Safai, M.D,

• Endodontics in Atherton, CA
• Providers in Atherton, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.