Individual provider Active NPI

Patrick Edward Oconnor, DDS

  • General Practice Dentistry
  • La Habra, CA
National Provider Identifier
1902902968
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28055 Issued in CA
Practice address
1400 W Imperial Hwy
I
La Habra, CA 90631
Phone
(562) 690-7796
Fax
(562) 690-3340
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 28055 CA Primary

Addresses

Primary practice location

1400 W Imperial Hwy
I
La Habra, CA 90631

Mailing address

1400 W Imperial Hwy
I
La Habra, CA 90631
Phone (562) 690-7796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160726002861 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1850684986

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Byun and Choi Dental Corp PastSince Aug 4, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902902968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W IMPERIAL HWY",
            "address_2": "I",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "90631",
            "telephone_number": "562-690-7796",
            "fax_number": "562-690-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W IMPERIAL HWY",
            "address_2": "I",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "90631",
            "telephone_number": "562-690-7796",
            "fax_number": "562-690-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "PATRICK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Habra, CA

Sources for this page

Verify at the official NPI Registry.