Sam C Olive Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2781 Issued in WV

Practice address

1628 West 3Rd Ave
Williamson, WV 25661

Phone

(304) 236-2366

NPI assigned

Feb 17, 2025

Last updated

Jan 5, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jason R Long DDS, PLLC

  • General Practice Dentistry
  • Williamson, WV
  • NPI 1255670063
  NPD (past)

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1922803592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 WEST 3RD AVE",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "25661",
            "telephone_number": "304-236-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 WEST 3RD AVE",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "25661",
            "telephone_number": "304-236-2366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1626 W 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Williamson",
            "state": "WV",
            "postal_code": "256613007",
            "country_code": "US",
            "telephone_number": "304-236-2366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVE",
        "first_name": "SAM",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-17",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "2781",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "2761",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ethan Noe
• Samantha Storm Noe
• Leigh Ann Noel
• Ohio Valley Physicians Inc (OVP Health)
• Ohio Valley Physicians Inc (OVP Health)
• Cheyanna Aaron Oneal
• Linda Renae Pack
• Leo Pantilla Pajarillo, M.D.
• Faith Elizabeth Parsley
• Samuel Jonathan Patrick

• Dentist in Williamson, WV
• Providers in Williamson, WV by specialty
• Dentist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.