Individual provider Active NPI

George Martin Olsen, DDS

  • Dentist
  • Missoula, MT
National Provider Identifier
1730233412
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00004703 Issued in WA
Practice address
237 SW Higgins Ave
Ste C
Missoula, MT 59803-1403
Phone
(406) 721-2830
Fax
(406) 549-5053
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 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 DE00004703 WA Primary
General Practice Dentistry 1223G0001X 1424 MT

Addresses

Primary practice location

237 SW Higgins Ave
Ste C
Missoula, MT 59803-1403

Mailing address

217 S 2ND Ave Ste C
Walla Walla, WA 99362-3002
Phone (406) 721-2830

Other practice location 1

217 S 2nd Ave
Walla Walla, WA 99362-3002
Phone (406) 370-5879

Other identifiers 2

IdentifierTypeStateIssuer
110162MedicaidMT
5511480OtherMTCHIP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE00004703WAMDDentist
1424MTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Missoula PC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1730233412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 S 2ND AVE STE C",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623002",
            "telephone_number": "406-721-2830",
            "fax_number": "406-549-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 SW HIGGINS AVE",
            "address_2": "STE C",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031403",
            "telephone_number": "406-721-2830",
            "fax_number": "406-549-5053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 S 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Walla Walla",
            "state": "WA",
            "postal_code": "993623002",
            "country_code": "US",
            "telephone_number": "406-370-5879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "GEORGE",
        "middle_name": "MARTIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00004703",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "1424",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110162",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP",
            "identifier": "5511480",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; 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.