MEDICARE: DR. OLGA SIMONA NASEA D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	30032	TX
2	122300000X	Dentist	019028141	IL
3	122300000X	Dentist	7167-15	WI

General Provider Information

NPI Number	:	1043547664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLGA SIMONA NASEA D.D.S.

Provider Business Mailing Address
First Line	:	1551 21ST ST
Second Line	:
City	:	BARABOO
State	:	WI
Zip	:	53913-3308
Country	:	US
Telephone Number	:	715-360-4644
Fax Number	:

Provider Business Practice Location Address
First Line	:	6668 ODANA RD
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53719-1012
Country	:	US
Telephone Number	:	817-776-7170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2009
Last Update Date	:	07/11/2025

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