Provider Demographics
NPI:1659269694
Name:O'DELL, ROBERT FORREST (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FORREST
Last Name:O'DELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 CHESTER ST UNIT 2423
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-2384
Mailing Address - Country:US
Mailing Address - Phone:909-374-1278
Mailing Address - Fax:
Practice Address - Street 1:10355 MARTIN LUTHER KING BLVD UNIT 110
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2390
Practice Address - Country:US
Practice Address - Phone:720-403-8351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00206321122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist