Mark Olsen, D.D.S.

Pediatric Dentistry · Star, ID

Individual Active NPI

NPI number 1780816652

Practice location

12192 Evely Pines Ln
Star, ID 83669
Phone
(208) 910-9000

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NPI record

NPI
1780816652
Entity type
Individual (Type 1)
Enumeration date
August 11, 2009
Last updated
February 20, 2020
Certified
February 20, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatric Dentistry Primary 1223P0221X D-5015-PD ID
General Practice Dentistry 1223G0001X 7371240-9921 UT

About Dr. Olsen

Mark Olsen, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatric Dentistry (code 1223P0221X). The practice location is 12192 Evely Pines Ln, Star, ID 83669. The NPI number 1780816652 was assigned on August 11, 2009 and the record was last updated on February 20, 2020.

Dr. Olsen lists 2 licenses in the registry: #D-5015-PD (ID) for Pediatric Dentistry; #7371240-9921 (UT) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark Olsen, D.D.S.?

The NPI number is 1780816652.

What is the phone number of Dr. Olsen?

The phone number listed for the practice location is (208) 910-9000.

Where is Dr. Olsen located?

12192 Evely Pines Ln, Star, ID 83669.

What is the taxonomy code for Dr. Olsen?

The primary taxonomy code is 1223P0221X – Pediatric Dentistry; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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