Robert Louis O'Donnell Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901022833 Issued in MI

Practice address

1550 W Sidney Rd
Sidney, MI 48885-9748

Phone

(877) 328-0777

NPI assigned

Oct 12, 2018

Last updated

Oct 12, 2018By 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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1821563115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 FERNDALE AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618347325",
            "telephone_number": "217-779-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 W SIDNEY RD",
            "city": "SIDNEY",
            "state": "MI",
            "postal_code": "488859748",
            "telephone_number": "877-328-0777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Ferndale Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "IL",
            "postal_code": "618347325",
            "country_code": "US",
            "telephone_number": "217-779-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "ROBERT",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-12",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901022833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Braden Galvin
• Adrianna Jane Haddix
• Sheri R Matthes
• Wendy A Wojcicki

• Dentist in Sidney, MI
• Providers in Sidney, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; 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.