1447299607 NPI number — DR. BARNEY T OLSEN D.D.S., M.S.

Table of content: DR. BARNEY T OLSEN D.D.S., M.S. (NPI 1447299607)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447299607 NPI number — DR. BARNEY T OLSEN D.D.S., M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLSEN
Provider First Name:
BARNEY
Provider Middle Name:
T
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S., M.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447299607
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7410 CREEK RD
Provider Second Line Business Mailing Address:
STE#200
Provider Business Mailing Address City Name:
SANDY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84093-6140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-562-5505
Provider Business Mailing Address Fax Number:
801-562-4545

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7410 CREEK RD
Provider Second Line Business Practice Location Address:
STE#200
Provider Business Practice Location Address City Name:
SANDY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84093-6140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-562-5505
Provider Business Practice Location Address Fax Number:
801-562-4545
Provider Enumeration Date:
06/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  267453-9922 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1223X0400X , with the licence number: 267453-8903 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com