Suzette A Olson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11599 Issued in MN

Practice address

74 1St Ave SE
Little Falls, MN 56345-3042

Phone

(320) 632-8113

Fax

(320) 632-5584

NPI assigned

Aug 22, 2006

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1740396571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 1ST AVE SE",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563453042",
            "telephone_number": "320-632-8113",
            "fax_number": "320-632-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 1ST AVE SE",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563453042",
            "telephone_number": "320-632-8113",
            "fax_number": "320-632-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "SUZETTE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "11599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan M Okoniewski-Philips, M.D.
• Chantel Lee Oldakowski, FNP
• Fatimah Adebukola Oloriegbe, MD
• Jacob Olson, PHARM.D.
• Stephen Donald Olson, DDS
• Amy Larayne Oothoudt, STS PROVIDER
• Linda Jean Pantzke, LMFT
• Paradox Chiropractic PA
• Saung Z Park, MD
• Phenom Rehab, Inc

• General Practice Dentistry in Little Falls, MN
• Providers in Little Falls, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.