Healthcare Provider Details
I. General information
NPI: 1518843002
Provider Name (Legal Business Name): OLIVIA GANGMARK STRICKLAND DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4 SUNSET WAY
HENDERSON NV
89014-2015
US
IV. Provider business mailing address
6655 NE TARA LN
BAINBRIDGE ISLAND WA
98110-4030
US
V. Phone/Fax
- Phone: 702-968-5222
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | LL-588-23 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: