DR. JACK CAPODICE MD DMD NPI 1053397612

NPI Details

DR. Jack Capodice, MD, DMD is an oral and maxillofacial pathology dentist in Bloomington, IL with 36 years of experience. The provider is the specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. DR. Jack Capodice, MD, DMD NPI is 1053397612. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduation Year:1990

The provider's business location address is:

109 N REGENCY DR
BLOOMINGTON, IL
ZIP 61701-515
Phone: (309) 663-2526
Fax: (309) 663-4788

The NPI 1053397612 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)

The enumeration date for this NPI number is 12/15/2005 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available: