Provider Demographics
NPI:1669438669
Name:DENNIS J O'CONNELL, DO, PC
Entity Type:Organization
Organization Name:DENNIS J O'CONNELL, DO, PC
Other - Org Name:INSIGHT RETINA CONSULTANTS, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:OCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-662-8400
Mailing Address - Street 1:15901 E BRIARWOOD CIR UNIT 100
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1781
Mailing Address - Country:US
Mailing Address - Phone:303-662-8400
Mailing Address - Fax:303-662-8677
Practice Address - Street 1:15901 E BRIARWOOD CIR UNIT 100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1781
Practice Address - Country:US
Practice Address - Phone:303-662-8400
Practice Address - Fax:303-662-8677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34076207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01340769Medicaid
COF58262Medicare UPIN
CO01340769Medicaid