NPIMap

Individual provider Active NPI

Andrew Charles Kearsley Olson, D.D.S.

  • General Practice Dentistry
  • Salt Lake City, UT
National Provider Identifier
1780095463
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9286307 Issued in UT
Practice address
2936 S Highland Dr
Ste 200
Salt Lake City, UT 84106-3582
Phone
(801) 486-2800
NPI assigned
May 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9286307 UT Primary

Addresses

Primary practice location

2936 S Highland Dr
Ste 200
Salt Lake City, UT 84106-3582

Mailing address

2936 S Highland Dr
Ste 200
Salt Lake City, UT 84106-3582
Phone (801) 486-2800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address AOLSON102797@DIRECT.MED.UTAH.EDU Direct University of Utah

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

LicenseStateTypeSpecialty
9286307UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Dental PC General Practice Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aolson102797@direct.med.utah.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1780095463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2936 S HIGHLAND DR",
            "address_2": "STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063582",
            "telephone_number": "801-486-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2936 S HIGHLAND DR",
            "address_2": "STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063582",
            "telephone_number": "801-486-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "ANDREW",
        "middle_name": "CHARLES KEARSLEY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-15",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "9286307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AOLSON102797@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.