Jacquelyn Faith Proulx, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN.00202643 Issued in CO

Practice address

1 Pickney Blvd.
Naval Hospital Beaufort
Beaufort, SC 29902

Phone

(941) 345-6180

NPI assigned

Sep 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacquelyn Faith Kasper Former name

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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1114396579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 ELMEN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770196107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PICKNEY BLVD.",
            "address_2": "NAVAL HOSPITAL BEAUFORT",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29902",
            "telephone_number": "941-345-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROULX",
        "first_name": "JACQUELYN",
        "middle_name": "FAITH",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00202643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "KASPER",
            "middle_name": "FAITH",
            "credential": "D.M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• PRN Staffers BSC, LLC
• Marsha Probst
• Profiles
• Eric John Prokopovich, DO
• Jenna Marie Prokopovich, RN BSN
• Publix Super Markets Inc
• Publix Super Markets, Inc.
• Kaitlin Putnam
• Dallas Pyron, CPSS
• Charles Thomas Quasney, DMD

• General Practice Dentistry in Beaufort, SC
• Providers in Beaufort, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.