Provider Demographics
NPI:1396763652
Name:OCONNELL, DENNIS J (DO)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:OCONNELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13111 E BRIARWOOD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3846
Mailing Address - Country:US
Mailing Address - Phone:720-443-2425
Mailing Address - Fax:720-328-5369
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:303-817-2105
Practice Address - Fax:720-328-5369
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34076207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO41271343Medicaid
CO41271343Medicaid
COF58262Medicare UPIN