Edward Lawrence Olson, DDS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

MN7908 Issued in MN

Practice address

816 W St Germain St
Suite 502
St Cloud, MN 56301

Phone

(320) 253-9868

Fax

(320) 255-0033

NPI assigned

Feb 21, 2007

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

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417092016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W ST GERMAIN ST",
            "address_2": "SUITE 502",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "56301",
            "telephone_number": "320-253-9868",
            "fax_number": "320-255-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 W ST GERMAIN ST",
            "address_2": "SUITE 502",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "56301",
            "telephone_number": "320-253-9868",
            "fax_number": "320-255-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "EDWARD",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MN",
            "license": "MN7908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John D Olsen, MD
• Aimee Olson, RD, LD
• Barbara Ford Olson, M.D.
• Cyndy Lee Olson, LPN
• Dillon Scott Olson, APRN
• Jessica Olson
• Jessica Mary Olson, B.A.
• Jodi Kay Olson, DNP, APRN, FNP-C
• Kasey Olson
• Kristin Olson

• Prosthodontics in St Cloud, MN
• Providers in St Cloud, MN by specialty
• Prosthodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.