NPIMap

Organization Active NPI

Olson Family Dental, PLLC

  • Dentist
  • Minot, ND
National Provider Identifier
1669886651
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1613 Issued in ND
Legal business name
OLSON FAMILY DENTAL, PLLC
Practice address
3725 Crossing Street SW
Suite B
Minot, ND 58701
Phone
(701) 852-4933
NPI assigned
Jun 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Authorized official

Name
Dr. David Clarence Olson, DDSNPI 1699829093
Title
Owner-Dentist
Phone
(701) 852-4933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 1613 ND Primary

Addresses

Primary practice location

3725 Crossing Street SW
Suite B
Minot, ND 58701

Mailing address

3725 Crossing Street SW
Suite B
Minot, ND 58701
Phone (701) 852-4933

Other identifiers 1

IdentifierTypeStateIssuer
40712MedicaidND

National Provider Directory

National Provider Directory

Locations

3725 Crossing St SW
#B
Minot, ND 58701
Phone (701) 852-4933

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537228800000",
    "number": "1669886651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 CROSSING STREET SW",
            "address_2": "SUITE B",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "58701",
            "telephone_number": "701-852-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 CROSSING STREET SW",
            "address_2": "SUITE B",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "58701",
            "telephone_number": "701-852-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLSON FAMILY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2018-09-18",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CLARENCE",
        "authorized_official_title_or_position": "OWNER-DENTIST",
        "authorized_official_telephone_number": "701-852-4933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ND",
            "license": "1613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40712",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.