Provider Demographics
NPI:1699736652
Name:O'CONNELL, MICHAEL S (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:O'CONNELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10715 N FRANK LLOYD WRIGHT BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-2691
Mailing Address - Country:US
Mailing Address - Phone:480-860-6000
Mailing Address - Fax:
Practice Address - Street 1:10715 N FRANK LLOYD WRIGHT BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-2691
Practice Address - Country:US
Practice Address - Phone:480-860-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ42571223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics