Brady J Olsen, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

7270739-9922 Issued in UT

Practice address

185 S 400 E Ste 201
Bountiful, UT 84010-4861

Phone

(801) 298-1101

Fax

(801) 298-1101

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wasatch Endodontics, PC

  • Exclusive Provider Organization
  • Bountiful, UT
  • NPI 1821428921
  NPD (past) Authorized official

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1609971043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 S 400 E STE 201",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104861",
            "telephone_number": "801-298-1101",
            "fax_number": "801-298-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S 400 E STE 201",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104861",
            "telephone_number": "801-298-1101",
            "fax_number": "801-298-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "BRADY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "7270739-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaname Kay Okawa, M.D.
• G. Scott Oldroyd, M.D.
• Anjali Oliver
• Melanie Oliver, GNP
• Jessalyn Ollerton
• Candland Lee Olsen, DDS
• Matthew James Olsen, DMD
• Phillip Peter Olsen, DMD
• Wayne Merlin Olsen, D.C.
• Gregory G. Oman, DDS

• Endodontics in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Endodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.