Individual provider Active NPI

Susan Olson, D.M.D

  • Student in an Organized Health Care Education/Training Program
  • Minneapolis, MN
National Provider Identifier
1730587007
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
R920 Issued in MN
Practice address
701 25TH Ave S Ste 400
Minneapolis, MN 55454-1443
Phone
(612) 659-4900
NPI assigned
Dec 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X R920 MN Primary

Addresses

Primary practice location

701 25TH Ave S Ste 400
Minneapolis, MN 55454-1443

Mailing address

701 25TH Ave S Ste 400
Minneapolis, MN 55454-1443
Phone (612) 659-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, SD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150804006299 NV Order and Referring Only - DentistPractitioner - Dentist 7810201811
I20221102002009 SD Order and Referring Only - DentistPractitioner - Dentist 7810201811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6555NVMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Susan Olson DMD Inc Past Accepting new patients
Lee MLK Dental Group, PC Past Accepting new patients
City of Sioux Falls Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: solson1473087@oc.providencedirect.org

Organizations & group practices 3

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": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1730587007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 25TH AVE S STE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541443",
            "telephone_number": "612-659-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 25TH AVE S STE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541443",
            "telephone_number": "612-659-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "SUSAN",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-18",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "R920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.