Active NPI
Marissa Olmos, DMD
- Dentist
- Gilbert, AZ
National Provider Identifier
1740021278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D012167
- Practice address
- 3341 E Queen Creek Rd
Gilbert, AZ 85297-8503 - Phone
- (480) 457-8877
- NPI assigned
- Jun 6, 2024
- Last updated
- May 17, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D012167 | AZ | Primary |
Addresses
Primary practice location
3341 E Queen Creek Rd
Gilbert, AZ 85297-8503
Mailing address
6117 E Edgemont Ave
Scottsdale, AZ 85257-1050
Phone (623) 824-2649
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
| License | State | Type | Specialty |
|---|---|---|---|
| D012167 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Bell Road Dental LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba DS Family General Dentistry
- General Practice Dentistry
- Scottsdale, AZ
- NPI 1649159518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778976000000",
"number": "1740021278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6117 E EDGEMONT AVE",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852571050",
"telephone_number": "623-824-2649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3341 E QUEEN CREEK RD",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852978503",
"telephone_number": "480-457-8877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLMOS",
"first_name": "MARISSA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-06",
"last_updated": "2026-05-17",
"certification_date": "2026-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D012167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.