Individual provider Active NPI

Steven William Olson, DDS

  • Dentist
  • Moses Lake, WA
National Provider Identifier
1720741804
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00007734 Issued in WA
Practice address
605 S Coolidge St
Moses Lake, WA 98837-1873
Phone
(509) 765-0674
NPI assigned
Oct 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D11473 OR
Dentist 122300000X DE00007734 WA Primary

Addresses

Primary practice location

605 S Coolidge St
Moses Lake, WA 98837-1873

Mailing address

9643 SE Shoreland Dr
Bellevue, WA 98004-6512
Phone (206) 510-7054

Other practice location 1

4700 42nd Ave SW Ste 530
Seattle, WA 98116-4561
Phone (206) 767-4851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240524002460 WA Order and Referring Only - DentistPractitioner - Dentist 4385086115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D11473ORMDDentist
DE00007734WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1720741804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9643 SE SHORELAND DR",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046512",
            "telephone_number": "206-510-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371873",
            "telephone_number": "509-765-0674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 42nd Ave SW Ste 530",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981164561",
            "country_code": "US",
            "telephone_number": "206-767-4851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "STEVEN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-15",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11473",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00007734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

Verify at the official NPI Registry.