Active NPI
Mary M. O'Connor, DDS, Inc
- Pediatric Dentistry
- San Diego, CA
National Provider Identifier
1700070646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 38072
- Legal business name
- MARY M. O'CONNOR, DDS, INC
- Practice address
- 420 Spruce St Ste a
San Diego, CA 92103-5859 - Phone
- (619) 291-5291
- Fax
- (619) 291-9755
- NPI assigned
- Sep 4, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mary Mildred O'Connor, D.D.S.
- Title
- President
- Phone
- (619) 291-5291
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 38072 | CA | Primary |
Addresses
Primary practice location
420 Spruce St Ste a
San Diego, CA 92103-5859
Mailing address
420 Spruce St Ste a
San Diego, CA 92103-5859
Phone (619) 291-5291
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 514126 | Other | CA | DENTI-CAL |
National Provider Directory
National Provider DirectoryLocations
420 Spruce St
Ste A
San Diego, CA 92103
Phone (619) 291-5291
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dentist
- San Diego, CA
- NPI 1215035217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188864000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1188864000000",
"number": "1700070646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 SPRUCE ST STE A",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921035859",
"telephone_number": "619-291-5291",
"fax_number": "619-291-9755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 SPRUCE ST STE A",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921035859",
"telephone_number": "619-291-5291",
"fax_number": "619-291-9755"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARY M. O'CONNOR, DDS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-09-04",
"last_updated": "2007-09-04",
"status": "A",
"authorized_official_last_name": "O'CONNOR",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "MILDRED",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "619-291-5291",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "38072",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL",
"identifier": "514126",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.