MEDICARE: DR. DENNIS J OCONNELL D.O.

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	207WX0107X	Retina Specialist (Ophthalmology) Physician	34076	CO
2	207W00000X	Ophthalmology Physician	34076	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396763652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS J OCONNELL D.O.

Provider Business Mailing Address
First Line	:	13111 E BRIARWOOD AVE STE 200
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-3846
Country	:	US
Telephone Number	:	720-443-2425
Fax Number	:	720-328-5369

Provider Business Practice Location Address
First Line	:	15901 E BRIARWOOD CIR UNIT 100
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80016-1781
Country	:	US
Telephone Number	:	303-817-2105
Fax Number	:	720-328-5369

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	04/02/2024

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