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General NPI Number Information
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NPI Number | 1043547664
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Entity Type | Individual
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Provider Name | OLGA SIMONA NASEA D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 6668 ODANA RD
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City | MADISON
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State | WI
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Zip | 53719-1012
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Country | US
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Telephone | 817-776-7170
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 21ST ST
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City | BARABOO
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State | WI
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Zip | 53913-3308
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Country | US
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Telephone | 715-360-4644
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30032
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019028141
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7167-15
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License Number State | WI
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