Active NPI
Katie Olson
- Dental Therapist
- Bloomington, MN
National Provider Identifier
1982148227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Therapist
- License
- DT65
- Practice address
- 8600 Nicollet Ave S
Bloomington, MN 55420 - Phone
- (952) 541-2888
- NPI assigned
- Dec 6, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dental Therapist | 125J00000X | DT65 | MN | Primary |
Addresses
Primary practice location
8600 Nicollet Ave S
Bloomington, MN 55420
Mailing address
8600 Nicollet Ave S
Bloomington, MN 55420-2824
Phone (952) 541-2888
Other practice location 1
1016 1st St S
Willmar, MN 56201-3510
Phone (320) 235-2010
Other practice location 2
1016 1st St S
Willmar, MN 56201-3510
Phone (320) 235-2010
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 |
|---|---|---|---|
| DT65 | MN | MD | Dental Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willmar Family Dentistry, PA | Past | Accepting new patients | |
| Willmar Family Dentistry, P.a. | Dental Therapist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Willmar, MN
- NPI 1376615450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554249600000",
"number": "1982148227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8600 NICOLLET AVE S",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554202824",
"telephone_number": "952-541-2888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8600 NICOLLET AVE S",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "55420",
"telephone_number": "952-541-2888"
}
],
"practiceLocations": [
{
"address_1": "1016 1st St S",
"address_purpose": "LOCATION",
"city": "Willmar",
"state": "MN",
"postal_code": "562013510",
"country_code": "US",
"telephone_number": "320-235-2010",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1016 1st St S",
"address_purpose": "LOCATION",
"city": "Willmar",
"state": "MN",
"postal_code": "562013510",
"country_code": "US",
"telephone_number": "320-235-2010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OLSON",
"first_name": "KATIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-06",
"last_updated": "2019-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "125J00000X",
"taxonomy_group": "",
"desc": "Dental Therapist",
"state": "MN",
"license": "DT65",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.