Jeffrey Charles Olson, DDS

Individual provider Active NPI General Practice Dentistry · Wailea, HI

NPI 1851735807 · NPPES record last updated Apr 22, 2013

Key facts

NPI
1851735807
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2487 (HI)
Practice address
161 Wailea Ike Dr
Ste B104
Wailea, HI 96753
Phone
(808) 875-8555
NPI assigned
Apr 22, 2013
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2487HIMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2487 HI Yes

Addresses

Primary practice location

161 Wailea Ike Dr
Ste B104
Wailea, HI 96753

Mailing address

161 Wailea Ike Dr
Ste B104
Wailea, HI 96753
Phone (808) 875-8555

Other providers in Wailea, HI

All providers in Wailea, HI · General Practice Dentistry in Hawaii

Sources for this page

Verify at the official NPI Registry.