=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669438669
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DENNIS J O'CONNELL, DO, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2006
-----------------------------------------------------
Last Update Date | 12/21/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15901 E BRIARWOOD CIR UNIT 100
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80016-1781
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-662-8400
-----------------------------------------------------
Fax | 303-662-8677
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15901 E BRIARWOOD CIR UNIT 100
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80016-1781
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-662-8400
-----------------------------------------------------
Fax | 303-662-8677
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN/OWNER
-----------------------------------------------------
Name | DR. DENNIS J OCONNELL
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 303-662-8400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 34076
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------