Brent Douglas Dupper, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

33633 Issued in TX

Practice address

1310 Ranch Road 620 S Ste B6
Lakeway, TX 78734-6346

Phone

(512) 263-0064

Fax

(909) 558-6469

NPI assigned

Jun 26, 2006

Last updated

Apr 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeway Dental Solutions. LLC

  • Dentist
  • Lakeway, TX
  • NPI 1538749270
  NPD Authorized official
• Dental Faculty Associates

  • General Practice Dentistry
  • Loma Linda, CA
  • NPI 1013435403
  NPD Authorized official
• Titanium Dental Group PLLC

  dba Lakeway Dental Associates

  • General Practice Dentistry
  • Lakeway, TX
  • NPI 1164305520
  NPD

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1942237284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 RANCH ROAD 620 S STE B6",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787346346",
            "telephone_number": "512-263-0064",
            "fax_number": "909-558-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 RANCH ROAD 620 S STE B6",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787346346",
            "telephone_number": "512-263-0064",
            "fax_number": "909-558-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPPER",
        "first_name": "BRENT",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36077",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yelena Dokic, MD
• Jill Alexandra Dorler, P.T.
• Nathan Drummond, MD
• Michelle Jeanne Dumbacher, OTR/L
• Emily Brown Dunlap, PT
• Ana M Duque, SLP
• Britt Duque, BCHN
• Tamala Duran, NBC-HWC
• Eaddy Dentistry PA
• Winston Marshall Eaddy, D.M.D., C.A.G.S.

• Dentist in Lakeway, TX
• Providers in Lakeway, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.