Provider Demographics
NPI:1770338782
Name:OLBERDING, DAKOTA G (PA)
Entity type:Individual
Prefix:
First Name:DAKOTA
Middle Name:G
Last Name:OLBERDING
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DAKOTA
Other - Middle Name:G
Other - Last Name:MCQUEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 SW 6TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1707
Mailing Address - Country:US
Mailing Address - Phone:785-354-8518
Mailing Address - Fax:785-354-1255
Practice Address - Street 1:2921 SW WANAMAKER DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5328
Practice Address - Country:US
Practice Address - Phone:785-272-6860
Practice Address - Fax:785-272-5839
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-03144363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant