Provider Demographics
NPI:1770673261
Name:JASPER EPPS, JOHN'E (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN'E
Middle Name:
Last Name:JASPER EPPS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JOHN'E
Other - Middle Name:JOHNETTE
Other - Last Name:JASPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:25 MEDICAL CENTER RD
Mailing Address - Street 2:
Mailing Address - City:GATES
Mailing Address - State:NC
Mailing Address - Zip Code:27937-9816
Mailing Address - Country:US
Mailing Address - Phone:252-357-4337
Mailing Address - Fax:
Practice Address - Street 1:25 MEDICAL CENTER RD
Practice Address - Street 2:
Practice Address - City:GATES
Practice Address - State:NC
Practice Address - Zip Code:27937-9816
Practice Address - Country:US
Practice Address - Phone:252-357-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC83011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905431Medicaid