Active NPI
Anthony Kent Olson, D.D.S.
- General Practice Dentistry
- Rochester, MN
National Provider Identifier
1982636189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11523
- Practice address
- 2112 Viking Dr NW
Rochester, MN 55901-3522 - Phone
- (507) 288-9192
- Fax
- (507) 288-0806
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11523 | MN | Primary |
Addresses
Primary practice location
2112 Viking Dr NW
Rochester, MN 55901-3522
Mailing address
2112 Viking Dr NW
Rochester, MN 55901-3522
Phone (507) 288-9192
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 |
|---|---|---|---|
| 11523 | MN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285545600000",
"number": "1982636189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2112 VIKING DR NW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559013522",
"telephone_number": "507-288-9192",
"fax_number": "507-288-0806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2112 VIKING DR NW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559013522",
"telephone_number": "507-288-9192",
"fax_number": "507-288-0806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "ANTHONY",
"middle_name": "KENT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2010-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "11523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.