Active NPI
Reid Harrison Olds, D.D.S.,PC
- General Practice Dentistry
- Okemos, MI
National Provider Identifier
1821031444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13188
- Practice address
- 2037 W Grand River
Okemos, MI 48864 - Phone
- (517) 349-9692
- Fax
- (517) 349-1231
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13188 | MI | Primary |
Addresses
Primary practice location
2037 W Grand River
Okemos, MI 48864
Mailing address
2037 W Grand River
Okemos, MI 48864
Phone (517) 349-9692
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2908188 | Medicaid | MI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13188 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821031444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2037 W GRAND RIVER",
"city": "OKEMOS",
"state": "MI",
"postal_code": "48864",
"telephone_number": "517-349-9692",
"fax_number": "517-349-1231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2037 W GRAND RIVER",
"city": "OKEMOS",
"state": "MI",
"postal_code": "48864",
"telephone_number": "517-349-9692",
"fax_number": "517-349-1231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLDS",
"first_name": "REID",
"middle_name": "HARRISON",
"name_prefix": "Mr.",
"credential": "D.D.S.,PC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "13188",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2908188",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Okemos, MI
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.