KELLY L OCONNOR DDS PC (NPI# 1700981552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700981552 |
| Entity Type | Organization |
| Organization Name | KELLY L OCONNOR DDS PC |
| Practice Address |
801 Main St Nw Bourbonnais IL 60914 |
| Practice Telephone | 8159323516 |
| Practice Fax Number | 8159323516 |
| Mailing Telephone | 8159323516 |
| Mailing Fax Number | 8159322992 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KELLY L OCONNOR (PRESIDENT) |
| Authorized Official Telephone | 8159323516 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | IL | Dental Providers |
| Street Address |
801 MAIN ST NW |
| City | BOURBONNAIS |
| State | IL |
| Zip Code | 60914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648023 | Jacob Daniel Ledesma | Physical Therapist | 588 William R Latham Senior Dr Ste 5, Bourbonnais, IL 60914 | 2020-10-30 |
| 1467069823 | Alicia Nicole Kendra | Nurse Practitioner | Upliftedcare, 482 Main St. Nw, Bourbonnais, IL 60914 | 2020-09-29 |
| 1043860877 | Victor Manuel Vazquez Cervantes | Pharmacist | 2080 No, Il-50, Bourbonnais, IL 60914 | 2019-09-13 |
| 1740843267 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N. Convent St Suite 1000, Bourbonnais, IL 60914 | 2019-04-19 |
| 1770074577 | Colin P Koerner | Physical Therapist | 215 N Convent St Ste 6, Bourbonnais, IL 60914 | 2018-05-29 |
| 1306337340 | Megan Hoskins | Behavior Technician | 3187 N 2420 W Rd., Bourbonnais, IL 60914 | 2018-05-25 |
| 1932600459 | Thomas H George Dds PC | Clinic/Center | 14 Briarcliff Professional Center, Bourbonnais, IL 60914 | 2018-02-21 |
| 1780193904 | Kathleen M Saindon II | Speech-Language Pathologist | 1021 Deer Trail, Bourbonnais, IL 60914 | 2017-09-20 |
| 1457870206 | Janet Mary Notton | Speech-Language Pathologist | 920 W Margaret Lane, Bourbonnais, IL 60914 | 2017-09-13 |
| 1134646375 | Sagar Batish | Student in an Organized Health Care Education/Training Program | 1096 Country Lane, Bourbonnais, IL 60914 | 2017-08-28 |
| Find all providers in zip 60914 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568949881 | Naimi Shah | Dentist | 761 Main St Nw Ste C, Bourbonnais, IL 60914-2343 | 2018-07-20 |
| 1144775578 | Niveditha Rajagopalan | Dentist | 1501 Il-50, Bourbonnais, IL 60914 | 2016-08-15 |
| 1023354388 | Mark Daniel Ryan | Dentist | 9 Briarcliff Prof Ctr, Ste D, Bourbonnais, IL 60914-2423 | 2012-12-13 |
| 1679818835 | Scott Paul Fogel | Dentist | 1521 N Convent St Ste 600, Bourbonnais, IL 60914-1486 | 2012-11-29 |
| 1962780817 | Yun Joo Jung | Dentist | 2034 N State Route 50 Ste 6, Bourbonnais, IL 60914-4410 | 2011-07-26 |
| 1194935759 | Bernard Eugene Ryan II | Dentist | 9 Briarcliff Professional Center, Suite D, Bourbonnais, IL 60914-2429 | 2007-05-23 |
| 1780717363 | Susan Patel | Dentist | 761 Main St Nw, Ste C, Bourbonnais, IL 60914-2333 | 2007-03-13 |
| 1346372695 | Thomas H George | Dentist | 14 Briarcliff Prof Ctr, Bourbonnais, IL 60914 | 2007-03-12 |
| 1528683430 | Bartlomiej D Lakomy | Dentist | 1501 N State Route 50, Bourbonnais, IL 60914-4429 | 2020-06-16 |
| 1811540081 | Ali Fahham | Dentist | 2034 N State Route 50, Bourbonnais, IL 60914-4410 | 2019-07-17 |
| Find all providers in BOURBONNAIS | ||||
| City | BOURBONNAIS |
| Zip Code | 60914 |
Please comment or provide details below to improve the information on KELLY L OCONNOR DDS PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.