Kevin M O'Dea, D.D.S., M.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

39553 Issued in CA

Practice address

10 Sierra Gate PLZ
Suite 190
Roseville, CA 95678-6645

Phone

(916) 786-3303

NPI assigned

Mar 25, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 13, 2016 through May 13, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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

• Kevin J. O'Neill, D.D.S., M.S.D., Inc.

  • Endodontics
  • Roseville, CA
  • NPI 1194980284
  NPD (past)

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649397480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SIERRA GATE PLZ",
            "address_2": "SUITE 190",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786645",
            "telephone_number": "916-786-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SIERRA GATE PLZ",
            "address_2": "SUITE 190",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786645",
            "telephone_number": "916-786-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DEA",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "39553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Marie O'Brien, DMD
• Eric Michael O'Connor
• Karen Edwards O'Connor
• Kyleiann Marie O'Connor, AMFT, APCC
• Morgan O'Connor, MD
• Amy P O'Donnell, M.S., L.AC
• Quinn Maura O'Hanlon
• McKenna O'Hara
• Kevin James O'Neill, D.D.S., M.S.D.
• Oak Creek Home Health Inc

• Endodontics in Roseville, CA
• Providers in Roseville, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.