Dr. Kelly D. O'Neal, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6086 Issued in CO

Legal business name

DR. KELLY D. O'NEAL, D.D.S.

Practice address

415 W Rockrimmon Blvd
Suite 200
Colorado Springs, CO 80919-1776

Phone

(719) 599-5340

Fax

(719) 598-0275

NPI assigned

Jan 31, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kelly Donald O'Neal, D.D.S.

Title

Dentist

Phone

(719) 599-5340

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1013256718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W ROCKRIMMON BLVD",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809191776",
            "telephone_number": "719-599-5340",
            "fax_number": "719-598-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W ROCKRIMMON BLVD",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809191776",
            "telephone_number": "719-599-5340",
            "fax_number": "719-598-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KELLY D. O'NEAL, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "O'NEAL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "719-599-5340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.