Mark Lavern Ohlsen

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10296 Issued in MN

Practice address

505 4TH St NW
Faribault, MN 55021-5032

Phone

(507) 334-7471

Fax

(507) 334-9736

NPI assigned

Mar 10, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Mark L Ohlsen

  dba The Dentists House LLC

  • Dentist
  • Faribault, MN
  • NPI 1740397611
  NPD (past) Authorized official
• The Dentists House LLC

  • General Practice Dentistry
  • Faribault, MN
  • NPI 1669634812
  NPD (past) Authorized official

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1962700245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 4TH ST NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215032",
            "telephone_number": "507-334-7471",
            "fax_number": "507-334-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 4TH ST NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215032",
            "telephone_number": "507-334-7471",
            "fax_number": "507-334-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHLSEN",
        "first_name": "MARK",
        "middle_name": "LAVERN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-10",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "10296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Jason Nomeland, D.D.S.
• Northfield Hospital (Northfield Hospital & Clinics - Faribault Clinic)
• Northstar Therapy Center LLC
• Kristina Nowak
• Jenny O'Malley, O.D.
• Joseph Oliver
• Bashir Omar I
• Bilal Omar
• Hassan Omar
• One Bread One Body MD LLC

• General Practice Dentistry in Faribault, MN
• Providers in Faribault, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; 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.

Verify at the official NPI Registry.