Individual provider Active NPI

Paul Scott Olin, D.D.S.

  • Prosthodontics
  • Minneapolis, MN
National Provider Identifier
1619011962
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
9708 Issued in MN
Practice address
516 Delaware St SE
7TH FL PWB Faculty Practice Clinic
Minneapolis, MN 55455-0356
Phone
(612) 626-3233
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 9708 MN Primary

Addresses

Primary practice location

516 Delaware St SE
7TH FL PWB Faculty Practice Clinic
Minneapolis, MN 55455-0356

Mailing address

516 Delaware St SE
Faculty Practice Clinic
Minneapolis, MN 55455-0356
Phone (612) 626-6529

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180811000023 MN Practitioner - Oral Surgery 4880593433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota Current Accepting new patients
Regents of the University of Minnesota CurrentSince Sep 1, 2018 Accepting new patients
Regents of the University of Minnesota CurrentSince Sep 1, 2018 Accepting new patients
Regents of the University of Minnesota Past Accepting new patients

Locations

515 Delaware St SE
Ste 7-521
Minneapolis, MN 55455

516 Delaware St SE
Fl 7
Minneapolis, MN 55455
Phone (612) 625-2495

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1619011962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 DELAWARE ST SE",
            "address_2": "FACULTY PRACTICE CLINIC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550356",
            "telephone_number": "612-626-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 DELAWARE ST SE",
            "address_2": "7TH FL PWB FACULTY PRACTICE CLINIC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550356",
            "telephone_number": "612-626-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIN",
        "first_name": "PAUL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MN",
            "license": "9708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.