Provider Demographics
NPI:1497837181
Name:O'CONNOR, BRENDAN GERARD (DDS MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:GERARD
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:DDS MD
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Mailing Address - Street 1:345 E 24TH ST
Mailing Address - Street 2:213 SCHWARTZ BLDG.,
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4020
Mailing Address - Country:US
Mailing Address - Phone:212-998-9329
Mailing Address - Fax:
Practice Address - Street 1:17411 HORACE HARDING EXPY
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-1527
Practice Address - Country:US
Practice Address - Phone:718-640-6498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2023-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY051592-11223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery