NPIMap

Organization Active NPI

Olivetree Dentistry PLLC

  • General Practice Dentistry
  • Sunnyvale, TX
National Provider Identifier
1801413018
Registry record updated Jul 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
OLIVETREE DENTISTRY PLLC
Practice address
184 S Collins Rd Ste 100
Sunnyvale, TX 75182-4636
Phone
(916) 878-9481
NPI assigned
Jul 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2020

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

Authorized official

Name
Merlin KoshyNPI 1821544073
Title
Owner
Phone
(916) 878-9481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

184 S Collins Rd Ste 100
Sunnyvale, TX 75182-4636

Mailing address

184 S Collins Rd Ste 100
Sunnyvale, TX 75182-4636

Other identifiers 1

IdentifierTypeStateIssuer
1821544073OtherNPPES

National Provider Directory

National Provider Directory

Locations

184 S Collins Rd
Ste 100
Sunnyvale, TX 75182
Phone (916) 878-9481

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593734400000",
    "number": "1801413018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 S COLLINS RD STE 100",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751824636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 S COLLINS RD STE 100",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751824636",
            "telephone_number": "916-878-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVETREE DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-03",
        "last_updated": "2020-07-03",
        "certification_date": "2020-07-03",
        "status": "A",
        "authorized_official_last_name": "KOSHY",
        "authorized_official_first_name": "MERLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-878-9481"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1821544073",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2020; 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.