Jacques Dupre

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7910 Issued in OK

Practice address

6958 Nebraska Ave
Fort Leonard Wood, MO 65473-1618

Phone

(573) 596-0411

NPI assigned

Aug 13, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

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": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1336558543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6958 NEBRASKA AVENUE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "65473",
            "telephone_number": "573-596-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6958 NEBRASKA AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654731618",
            "telephone_number": "573-596-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPRE",
        "first_name": "JACQUES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-13",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029993",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "319019139",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2024009465",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "7910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Lee Downing Jr., RDN
• Zaine Robert Dugan
• Stephen Lindsey Dunaway, LCSW
• Braxton Stanley Duncan, DDS
• Debra A Duncan, MSW
• Marinda Ann Earl, OPTOMETRY TECH.
• Benjamin Earle, PA-C
• Yahely Echavarria
• Deidra Marie Edwards, PT
• Nathan Alan Elkins, HEALTH CARE SPC

• General Practice Dentistry in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.