Jason Samuel Olitsky

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN15791 Issued in FL

Practice address

818 A1A N
Suite 209
Ponte Vedra Beach, FL 32082-3295

Phone

(904) 273-1723

Fax

(904) 273-1726

NPI assigned

Dec 2, 2010

Last updated

Dec 2, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1730481359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 A1A N",
            "address_2": "SUITE 209",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823295",
            "telephone_number": "904-273-1723",
            "fax_number": "904-273-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 A1A N",
            "address_2": "SUITE 209",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823295",
            "telephone_number": "904-273-1723",
            "fax_number": "904-273-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLITSKY",
        "first_name": "JASON",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renata Nosek, M.A.
• James November, PHD
• Elizabeth Cox Nurrenbrock, M.A. CCC-SLP
• Tracey O'Neill, CNS, LDN
• Occuplay Inc
• Erica Oppenheimer, LMSW
• Nina Oriolo, BSN
• Emily Ortiz
• Aylin Ozdemir, M.D.
• Richard G Packo, DC

• General Practice Dentistry in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.