Jaclyn Kupper Cattanach, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5971C1 Issued in AL

Practice address

155 S Main St
West Hartford, CT 06107-3450

Phone

(860) 530-6700

NPI assigned

Jul 1, 2011

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

• Jaclyn Laura Kupper Former name

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.

• Dandridge Dental PC

  dba Dandridge Dental Family Dentistry

  • Exclusive Provider Organization
  • Dothan, AL
  • NPI 1962793893
  NPD (past)

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647043200000",
    "number": "1821385543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 S MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061073450",
            "telephone_number": "860-539-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 S MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061073450",
            "telephone_number": "860-530-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATTANACH",
        "first_name": "JACLYN",
        "middle_name": "KUPPER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2022-03-12",
        "certification_date": "2022-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5971C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "KUPPER",
            "middle_name": "LAURA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Giovannia Casseus, OTD
• Cassidy M Olio LPC,LLC
• Diana Laura Castellanos, PA
• Theresa Marie Castillejo
• Aliza Castro
• Deborah Cavanaugh, MS, LPC
• Michelle L Cavo, PA
• Joseph Santo Cellini
• Center for Dental Excellence, LLC
• Central Conn Endodontics, PC

• General Practice Dentistry in West Hartford, CT
• Providers in West Hartford, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2022; 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.