Individual provider Active NPI

William Harold Olson, DDS

  • Dentist
  • Grand Forks, ND
National Provider Identifier
1801994124
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1556 Issued in ND
Practice address
2810 17TH Ave South
Grand Forks, ND 58201-4010
Phone
(701) 775-0641
Fax
(701) 746-9328
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1556 ND Primary

Addresses

Primary practice location

2810 17TH Ave South
Grand Forks, ND 58201-4010

Mailing address

2810 17TH Ave South
Grand Forks, ND 58201-4010
Phone (701) 775-0641

Other identifiers 2

IdentifierTypeStateIssuer
788399OtherUNITED CONCORDIA
901556OtherNDDENTAL SERVICES CORP

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
1556NDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dakota Dental Associates PC Dentist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801994124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 17TH AVE SOUTH",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014010",
            "telephone_number": "701-775-0641",
            "fax_number": "701-746-9328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 17TH AVE SOUTH",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014010",
            "telephone_number": "701-775-0641",
            "fax_number": "701-746-9328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "WILLIAM",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "1556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "788399",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL SERVICES CORP",
            "identifier": "901556",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.