Active NPI
Robert Olan, DDS
- Periodontics
- Whitestone, NY
National Provider Identifier
1881684058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 042258
- Practice address
- 1815 Francis Lewis Blvd
Whitestone, NY 11357-3836 - Phone
- (718) 767-7276
- NPI assigned
- Oct 27, 2005
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 042258 | NY | Primary |
Addresses
Primary practice location
1815 Francis Lewis Blvd
Whitestone, NY 11357-3836
Mailing address
1815 Francis Lewis Blvd
Whitestone, NY 11357-3836
Phone (718) 767-7276
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150717001835 | NY | Order and Referring Only - Oral Surgery | 4284947342 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398643200000",
"number": "1881684058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 FRANCIS LEWIS BLVD",
"city": "WHITESTONE",
"state": "NY",
"postal_code": "113573836",
"telephone_number": "718-767-7276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1815 FRANCIS LEWIS BLVD",
"city": "WHITESTONE",
"state": "NY",
"postal_code": "113573836",
"telephone_number": "718-767-7276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLAN",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-27",
"last_updated": "2014-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "042258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whitestone, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.