Alex John Olson, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2022008320 Issued in MO

Practice address

2602 S Picher Ave
Joplin, MO 64804-1641

Phone

(417) 781-2220

NPI assigned

Feb 27, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

Practice roles

Locations

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

• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Pittsburg, KS
  • NPI 1669474425

  Single Specialty

  Medicare reassignment NPD
• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Baxter Springs, KS
  • NPI 1487351086
  NPD
• Benjamin D Rosenberg DDS Inc

  • Pediatric Dentistry
  • Joplin, MO
  • NPI 1871984609
  NPD (past)
• Moc Joplin, PLLC

  dba Joplin Children's Dentistry

  • Dentist
  • Joplin, MO
  • NPI 1265096325
  NPD (past)
• Moc Webb City, P L L C

  • Dentist
  • Webb City, MO
  • NPI 1013542232
  NPD (past)

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1598399602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 S PICHER AVE",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 S PICHER AVE",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041641",
            "telephone_number": "417-781-2220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4441 Diplomacy Dr",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995085910",
            "country_code": "US",
            "telephone_number": "907-729-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3011 N Michigan St",
            "address_purpose": "LOCATION",
            "city": "Pittsburg",
            "state": "KS",
            "postal_code": "667622546",
            "country_code": "US",
            "telephone_number": "620-231-9873",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Commerce Dr",
            "address_purpose": "LOCATION",
            "city": "Parsons",
            "state": "KS",
            "postal_code": "673574951",
            "country_code": "US",
            "telephone_number": "620-717-4450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "ALEX",
        "middle_name": "JOHN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-27",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "172407",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KS",
            "license": "61833",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2022008320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coeta Sue Ogle, FNP-C
• Nicole Ogle, FNP-C
• Adetokunbo Olawuyi, BDS, DMSC
• Paul Milton Olive, M.D.
• Olson Chiropractic PC
• Brenton L Olson, DC
• Cassandra E Olson, NP-C
• Dennis Ray Olson, D.C.
• Stacia M Olson
• Oncology and Hematology Center, P.C.

• Pediatric Dentistry in Joplin, MO
• Providers in Joplin, MO by specialty
• Pediatric Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.