DR. JUSTIN OLSEN (NPI# 1144570367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144570367 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN OLSEN |
| Credential | DDS |
| Practice Address |
3551 Roger Brooke Dr Fort Sam Houston TX 78234-4504 |
| Mailing Address |
24245 Wilderness Oak Apt 2806 San Antonio TX 78258-7860 |
| Practice Telephone | 2109160332 |
| Mailing Telephone | 4355123442 |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 0401413760 | VA | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
33515 | TX | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1202 W Bitters Rd Bldg 6, San Antonio, TX 782167852 | 2104910015 | 2104910352 |
| 715 Hill Country Dr Ste 6, Kerrville, TX 780285965 | 8308960056 | 8308960039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982902359 | Justin G Olsen | Counselor | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2011-03-08 |
| 1336302249 | Justin T Olsen | Dentist | 1201 N. Stonewall Ave, Post Office Box 26901, Oklahoma City, OK 73190-3044 | 2008-07-10 |
| 1770781437 | Justin Paul Olsen | Surgery | 7315 212th St Sw, Suite 201, Edmonds, WA 98026-7610 | 2007-07-04 |
| Street Address |
3551 ROGER BROOKE DR |
| City | FORT SAM HOUSTON |
| State | TX |
| Zip Code | 78234-4504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093338 | Aneesh N/a Benoy | Nurse Practitioner | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-11-02 |
| 1164021580 | William Edward Vick | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-19 |
| 1548868003 | Julia D Coffey | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-15 |
| 1801493465 | Emiri Elliott | Registered Nurse | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-07 |
| 1437756574 | Clarence Michael Sullivan | Military Health Care Provider | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-10-01 |
| 1093320350 | Natalie Marie Greene | Physical Therapist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-09-14 |
| 1033722509 | Kody Vallejo | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-08-25 |
| 1558972620 | Renee Therese Hart | Nurse Practitioner | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-08-12 |
| 1235749722 | Emily Ann Robinson | Nurse Practitioner | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-08-09 |
| 1902415367 | Hannah Daniel | Pharmacist | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2020-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942884 | Thomas Ballas | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa-fort Sam Houston, Department of Behavioral Medicine-mche-dbm, San Antonio, TX 78234 | 2020-08-17 |
| 1124657366 | Wendy Harris | Pharmacist | 3041 Garden Ave, Fort Sam Houston, TX 78234 | 2020-04-08 |
| 1215564729 | Travis Frantz | Student in an Organized Health Care Education/Training Program | 3551 Rodger Brooke Drive, Jbsa Fort Sam Houston, TX 78234 | 2020-03-25 |
| 1508492695 | Matthew Grossmann | Student in an Organized Health Care Education/Training Program | San Antonio Military Medical Center, Mche-zdm-m, Internal Medicine Residency, 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234 | 2020-03-20 |
| 1235793407 | Jessica Maria May Franklin | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa Fort Sam Houston, San Antonio, TX 78234 | 2019-04-23 |
| 1730663477 | Glen Snyder | Military Health Care Provider | 3488 Garden Ave Anderson Hall, Fort Sam Houston, San Antonio, TX 78234 | 2018-09-19 |
| 1265919336 | Ashley Elizabeth Malawey | Military Health Care Provider | 3222 Cpl Johnson Road, San Antonio, TX 78234 | 2018-07-23 |
| 1053805515 | Rene Espinosa | Social Worker | San Antonio Medical Center, 3551 Roger Brooke Dr, Jbsa, TX 78234 | 2018-06-19 |
| 1235622333 | Melanie Edith Rivera | Military Health Care Provider | 3600 Roger Brooke Drive, San Antonio, TX 78234 | 2018-06-13 |
| 1063909158 | Benjamin Walker Appelo | General Practice | San Antonio Mil Med Center 3551 Roger Brooke Dr, Mche-zdm-m, San Antonio, TX 78234 | 2018-04-16 |
| Find all providers in zip 78234 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033266549 | Timothy A. Lew | Dentist | 1811 Army Blvd, Usa Dentac Ft Sam Houston, Fort Sam Houston, TX 78234-2686 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720337 | Texas Wisdom Teeth Specialists | Dentist | 8409 W Cleburne Rd, Fort Worth, TX 76123-1421 | 2020-11-04 |
| 1932716859 | Gentle Dentistry Inc | Dentist | 1810 S Bowen Rd Ste A, Arlington, TX 76013-3340 | 2020-09-24 |
| 1568080497 | San Antonio Wisdom Teeth, Pllc | Dentist | 13535 Hausman Pass #102-a, San Antonio, TX 78249 | 2020-07-07 |
| 1033733365 | Ernesto Carmona Jr Dds PC | Dentist | 10125a Lake Creek Pkwy, Austin, TX 78729-1711 | 2020-06-02 |
| 1437779691 | Kendall Implant and Oral Surgery | Dentist | 109 Falls Ct Ste 700, Boerne, TX 78006-2984 | 2020-04-17 |
| 1285273847 | Cardenas Dental Implants and Oral Surgery | Dentist | 5460 Paredes Line Rd Ste 197a, Brownsville, TX 78526-9742 | 2019-12-31 |
| 1770134876 | Red River Oral Surgery | Dentist | 4616 Highway 75, Suite 201, Denison, TX 75020 | 2019-09-20 |
| 1316594120 | Mona Stone Dds LLC | Dentist | 4863 Allencrest Ln, Dallas, TX 75244-7710 | 2019-08-26 |
| 1821640822 | Guillen Rivera Oral and Maxillofacial Surgery Pllc | Dentist | 7100 Westwind Dr Ste 110-115, El Paso, TX 79912-1786 | 2019-07-10 |
| 1073173274 | Woodlands Oral & Maxillofacial Surgery | Dentist | 4850 W. Panther Creek Drive Suite 106, The Woodlands, TX 77381 | 2019-06-19 |
| Find all providers with the same taxonomy | ||||
| City | FORT SAM HOUSTON |
| Zip Code | 78234 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.