DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JASON JOHN TUPPER, BDS

Deactivated Sole Proprietor

DR. JASON JOHN TUPPER, BDS is a General Dentistry healthcare provider located in EDWARDSVILLE, Illinois. NPI 1457088965 is deactivated in the NPPES registry. Verify at CMS.

General Dentistry · EDWARDSVILLE, IL

This NPI has been deactivated. The record was deactivated on March 13, 2023. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1457088965
Provider Type
Individual
Gender
Male
NPI Issued
Aug 4, 2022 (0.60547945205479 yrs)
Last Updated
Oct 22, 2025
Deactivated
Mar 13, 2023
Licenses
2025011907 (MO)
019.036573 (IL)
Sole Proprietor
Yes

Practice Information

Address
600 COUNTRY CLUB VW STE 4
EDWARDSVILLE, IL, 620253638
Browse IL providers · Browse ZIP 62025
Phone
6183073267
Primary Specialty
General Dentistry
1223G0001X
Additional Specialty
Pediatric Dentistry

Other General Dentistry Providers in EDWARDSVILLE, IL

Name Credential NPI
DR. DALE GLEN CLAUSSEN DMD 1780687293
BRENT DOUGLAS WOHLFORD D.M.D. 1245246818
DR. DANIELLE R CSASZAR DMD 1386702785
DR. GARY MICHAEL FISCHER DMD 1801952403
DR. DAVID W HYTEN DMD 1558416511
DR. SHARON E HANNE DMD 1649317702
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.