Active NPI
Oscar Olavarria
- Orthodontics and Dentofacial Orthopedics Dentistry
- Jacksonville, FL
National Provider Identifier
1497272405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DTP661
- Practice address
- 2800 University Blvd N
Jacksonville, FL 32211-3321 - Phone
- (904) 256-7858
- Fax
- (904) 256-7798
- NPI assigned
- Aug 30, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DTP661 | FL | Primary |
Addresses
Primary practice location
2800 University Blvd N
Jacksonville, FL 32211-3321
Mailing address
2800 University Blvd N
Jacksonville, FL 32211-3321
Phone (904) 256-7858
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
| License | State | Type | Specialty |
|---|---|---|---|
| DTP661 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1497272405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 UNIVERSITY BLVD N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322113321",
"telephone_number": "904-256-7858",
"fax_number": "904-256-7798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 UNIVERSITY BLVD N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322113321",
"telephone_number": "904-256-7858",
"fax_number": "904-256-7798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLAVARRIA",
"first_name": "OSCAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-30",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "FL",
"license": "DTP661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.