Scot A O'Donnell, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

18824 Issued in TX

Practice address

14362 W State Highway 29 Ste 101
Liberty Hill, TX 78642-4902

Phone

(512) 548-5040

Fax

(512) 548-5040

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pflugerville Orthodontics PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pflugerville, TX
  • NPI 1073631107
  NPD (past) Authorized official

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1598833550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14362 W STATE HIGHWAY 29 STE 101",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786424902",
            "telephone_number": "512-548-5040",
            "fax_number": "512-548-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14362 W STATE HIGHWAY 29 STE 101",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786424902",
            "telephone_number": "512-548-5040",
            "fax_number": "512-548-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "SCOT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "18824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1073631107",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI- TYPE 1",
            "identifier": "1598833550",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "47-0853393",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Sue Nickle, PT
• Hari Priya Nistala
• Alyssa Raelyn Nottingham
• Stacy Novick, FNP-C
• Erica Suzanne O'Brien, OD
• Maeve O'Neill, LPC, MAC
• Promise Okeh, FNP-C
• Deborah Okrina, LCSW
• Jesse Opela
• Conard Jay Osbourn, RN

• Orthodontics and Dentofacial Orthopedics Dentistry in Liberty Hill, TX
• Providers in Liberty Hill, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.