Jack Capodice, MD, DMD
Oral & Maxillofacial Surgery · Bloomington, IL
UnclaimedMD, DMDNPI 1053397612
- Primary taxonomy
- 1223S0112X
- Enumerated
- 2005-12-15
- Practice location
- Bloomington, IL
- Last NPPES update
- 2026-04-06
State licenses
- IL · Dentist · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.