Jason John Tupper, BDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2025011907 Issued in MO

Practice address

600 Country Club VW Ste 4
Edwardsville, IL 62025-3638

Phone

(618) 307-3267

NPI assigned

Aug 4, 2022

Reactivated

Nov 28, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Harvey H Breckner D.M.D.,M.S

  • Exclusive Provider Organization
  • Edwardsville, IL
  • NPI 1447415757
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1457088965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 LACLEDE AVE UNIT 211",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COUNTRY CLUB VW STE 4",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253638",
            "telephone_number": "618-307-3267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University of Tennessee Health Science Centre",
            "address_2": "875 Union Ave Dunn Building,",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "38103",
            "country_code": "US",
            "telephone_number": "901-448-6468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Westbury Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633012560",
            "country_code": "US",
            "telephone_number": "636-723-6071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUPPER",
        "first_name": "JASON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "BDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "deactivation_date": "2023-03-13",
        "reactivation_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2025011907",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "019.036573",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori J Tretter
• Leah Marie Trower, APRN, FNP-BC
• Kelsey Michele True, RD
• Sarvi Tsering
• Anna Maria Tucker, BT
• Kelechi Uche Uduma
• Natalia Ummel
• Jamie L Unger, SSP
• University Care Center, LLC
• Maria Rose Vahling

• General Practice Dentistry in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.