DR. JEREMY DANIEL OLEN (NPI# 1396175741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396175741 |
| Entity Type | Individual |
| Full Name | DR. JEREMY DANIEL OLEN |
| Credential | D.M.D. |
| Practice Address |
323 Blue Valley Dr Bangor PA 18013-1526 |
| Practice Telephone | 6105881571 |
| Practice Fax Number | 6105880571 |
| Mailing Telephone | 6105881571 |
| Mailing Fax Number | 6105880571 |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2019-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DS039661 | PA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3465 Nazareth Rd Ste 200, Easton, PA 180458359 | 6109230100 | 6109230115 |
| Street Address |
323 BLUE VALLEY DR |
| City | BANGOR |
| State | PA |
| Zip Code | 18013-1526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104298140 | Blue Valley Vision LLC | Eyewear Supplier (Equipment, not the service) | 455 Blue Valley Dr, Bangor, PA 18013 | 2015-10-29 |
| 1588064554 | Roxanne Decesare | Reflexologist | 429 South First St, Bangor, PA 18013 | 2014-08-27 |
| 1467781708 | Shadys Rest | Preferred Provider Organization | 1004 W Juniata Street, Allentown, PA 18013 | 2009-12-16 |
| 1912911371 | Richard J Weaver | Chiropractor | 83 Bangor Junction Road, Blue Valley Plaza, Bangor, PA 18013 | 2006-07-28 |
| 1104373265 | Heavenly Vision | Technician/Technologist | 455 Blue Valley Dr, Bangor, PA 18013 | 2016-09-07 |
| 1881059293 | Timothy James Velekei Sr. | Technician/Technologist | 455 Blue Valley Dr, Bangor, PA 18013 | 2015-12-30 |
| 1629492608 | Elizabeth Kostura | Counselor | 51 Market Street, Bangor, PA 18013 | 2014-02-11 |
| 1518261593 | Carol Augusta Olzinski | Social Worker | 51 Market Street, Bangor, PA 18013 | 2011-01-05 |
| 1073846390 | Christa Robinson | Specialist/Technologist | 19 Columbus St, Apt 3, Roseto, PA 18013 | 2009-09-18 |
| 1326096587 | Matthew Nicholas Sabatine Jr. | Dentist | 137 Broadway, Bangor, PA 18013 | 2006-05-04 |
| Find all providers in zip 18013 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124644950 | Robert Thibeault Brookings | Dentist | 39 Grove Street, Bangor, ME 04401-5309 | 2020-06-17 |
| 1437599933 | Rachel Ann Lukas | Dentist | 62 Corporate Drive, Bangor, ME 04401 | 2013-06-28 |
| 1417247362 | Vinh Hien Dao | Dentist | 728 Stillwater Ave, Bangor, ME 04401-3615 | 2011-04-12 |
| 1902001225 | Gary Warren Fessler | Dentist | 16 Grove Street, Bangor, ME 04401 | 2007-06-18 |
| 1659574051 | Wayne Wilson Wibby | Dentist | 20 Bellevue Ave, Bangor, ME 04401-5618 | 2007-06-06 |
| 1669691697 | Michael Leonard Pacifico | Dentist | 48 N 3rd St, Bangor, PA 18013-1908 | 2007-04-25 |
| 1063563948 | Mark Edward Eggleton | Dentist | 715 Hammond St, Bangor, ME 04401-4515 | 2007-01-16 |
| 1851487169 | Randy Joseph Heard | Dentist | 226 Broadway, Bangor, PA 18013-2528 | 2006-10-05 |
| 1881791911 | Robert L Brookings | Dentist | 39 Grove St, Bangor, ME 04401-5309 | 2006-09-20 |
| 1346251378 | Randon E. Bragdon | Dentist | 30 Judson Blvd, Bangor, ME 04401-2518 | 2006-08-11 |
| Find all providers in BANGOR | ||||
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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.