Individual provider Active NPI

Taelor Lynn Duprey, DMD

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1366018103
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN25861 Issued in FL
Practice address
12667 Beach Blvd
Jacksonville, FL 32246-7172
Phone
(904) 250-5530
NPI assigned
Jun 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN25861 FL Primary

Addresses

Primary practice location

12667 Beach Blvd
Jacksonville, FL 32246-7172

Mailing address

14698 Bartram Creek Blvd
Jacksonville, FL 32259-7061
Phone (904) 315-3347

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN25861FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Comfortable Care Dental Health Professionals, P.a. General Practice CurrentSince Jun 6, 2021 Accepting new patients

Locations

12667 Beach Blvd
Jacksonville, FL 32246
Phone (904) 204-1542

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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1366018103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14698 BARTRAM CREEK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322597061",
            "telephone_number": "904-315-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12667 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467172",
            "telephone_number": "904-250-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPREY",
        "first_name": "TAELOR",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.