Active NPI
Olivia Catherine Crane
- General Practice Dentistry
- Blaine, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D14040
- Practice address
- 1384 109TH Ave NE Ste 200
Blaine, MN 55434-4543 - Phone
- (763) 757-6000
- NPI assigned
- Mar 9, 2018
- Last updated
- May 31, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | D14040 | MN | Primary |
Addresses
Primary practice location
1384 109TH Ave NE Ste 200
Blaine, MN 55434-4543
Mailing address
7302 177TH Ave NE
Columbus, MN 55025-8875
Phone (641) 420-3764
Other practice location 1
3450 Lacey Rd
Downers Grove, IL 60515-5430
Phone (630) 743-4500
Other practice location 2
1970 Buerkle Rd
Saint Paul, MN 55110
Phone (651) 337-5695
Other practice location 3
1970 Buerkle Rd
Saint Paul, MN 55110
Phone (651) 337-5695
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190719000846 | MN | Order and Referring Only - Dentist | 0547596165 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D14040 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White Bear Dentists, PC | General Practice | Past | Accepting new patients |
| Blaine Dentistry, PC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba White Bear Dentists
- General Practice Dentistry
- White Bear Lake, MN
- NPI 1558725598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1679076376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7302 177TH AVE NE",
"city": "COLUMBUS",
"state": "MN",
"postal_code": "550258875",
"telephone_number": "641-420-3764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1384 109TH AVE NE STE 200",
"city": "BLAINE",
"state": "MN",
"postal_code": "554344543",
"telephone_number": "763-757-6000"
}
],
"practiceLocations": [
{
"address_1": "3450 Lacey Rd",
"address_purpose": "LOCATION",
"city": "Downers Grove",
"state": "IL",
"postal_code": "605155430",
"country_code": "US",
"telephone_number": "630-743-4500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1970 Buerkle Rd",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "55110",
"country_code": "US",
"telephone_number": "651-337-5695",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1970 Buerkle Rd",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "55110",
"country_code": "US",
"telephone_number": "651-337-5695",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CRANE",
"first_name": "OLIVIA",
"middle_name": "CATHERINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-09",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D14040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Blaine, MN
- Coon Rapids Chiropractic Health Services LTD
- Haley Copenhaver
- Core Restore Counseling, LLC
- Ian Manuel Guerrero Corpus, M.D.
- Corrective Care Chiropractic PC
- Crest View Corporation (Crest View Senior Community at Blaine)
- Jennifer Cunningham
- Ann Curren, RPH,PHARMD
- Enrique Gabriel Cuzco I
- Amy Elizabeth Dahlgren, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.