Stephen Patrick O'Donnell, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DDS104542 Issued in CA

Practice address

5550 Carmel Mountain Rd Ste 200
San Diego, CA 92130-4861

Phone

(619) 630-4000

NPI assigned

Apr 25, 2019

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1669036505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11580 COMPASS POINT DR N APT 61",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921268556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 CARMEL MOUNTAIN RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921304861",
            "telephone_number": "619-630-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7720 Rancho Santa Fe Rd Ste 215",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920098685",
            "country_code": "US",
            "telephone_number": "760-635-5995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 Orange Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Coronado",
            "state": "CA",
            "postal_code": "921182662",
            "country_code": "US",
            "telephone_number": "619-435-6655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "STEPHEN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-25",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DDS104542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aubrey Brophy O'Donnell, RD, CSR
• Austin James O'Donnell
• Frances Jane Durham O'Donnell, M.D.
• Laura A. O'Donnell, M.D.
• Robert H. O'Donnell, M.D.
• Kristen Marie O'Dwyer, LCSW
• Mary Margaret O'Dwyer, M.D.
• Kathleen Anne O'Farrell, M.D.
• Kate Michelle O'Flaherty-Keese, P.N.P.
• Elizabeth A. O'Grady, LCSW

• Pediatric Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.