Olivia Raye Fisher

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

09870 Issued in IA

Practice address

550 Pond View Dr Ste 2
North Liberty, IA 52317-2507

Phone

(319) 459-1975

Fax

(319) 335-7451

NPI assigned

Feb 12, 2019

Sex

Female

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

Practice roles

Locations

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.

• Corridor Endodontics LLC

  dba Corridor Endodontics

  • Endodontics
  • North Liberty, IA
  • NPI 1033724679
  NPD
• Corridor Endodontics PC

  • Dental Clinic/Center
  • North Liberty, IA
  • NPI 1326454042
  NPD (past)

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1730645078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 POND VIEW DR STE 2",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523172507",
            "telephone_number": "319-459-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 POND VIEW DR STE 2",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523172507",
            "telephone_number": "319-459-1975",
            "fax_number": "319-335-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "OLIVIA",
        "middle_name": "RAYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IA",
            "license": "09870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Fomak Transportation,LLC
• Tayler Foster
• Foundations First, LLC

• Endodontics in North Liberty, IA
• Providers in North Liberty, IA by specialty
• Endodontics in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.