Active NPI
Robert Wayne Olsen, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Kalispell, MT
National Provider Identifier
1881310266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 23787
- Practice address
- 34 Bruyer Way
Kalispell, MT 59901-6305 - Phone
- (503) 884-7906
- NPI assigned
- Oct 17, 2022
- Last updated
- Oct 17, 2022
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 23787 | MT | Primary |
Addresses
Primary practice location
34 Bruyer Way
Kalispell, MT 59901-6305
Mailing address
94012 Range Road 215
Lethbridge County, ALBERTA T1J 5R4
CA
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23787 | MT | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1881310266",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "94012 RANGE ROAD 215",
"city": "LETHBRIDGE COUNTY",
"state": "ALBERTA",
"postal_code": "T1J 5R4"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 BRUYER WAY",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599016305",
"telephone_number": "503-884-7906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSEN",
"first_name": "ROBERT",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-17",
"last_updated": "2022-10-17",
"certification_date": "2022-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MT",
"license": "23787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalispell, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.