Provider Demographics
NPI:1861247611
Name:BRUPPACHER, JOHN HERMAN (DMD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HERMAN
Last Name:BRUPPACHER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 N MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3235
Mailing Address - Country:US
Mailing Address - Phone:201-797-8899
Mailing Address - Fax:201-797-8484
Practice Address - Street 1:89 N MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3235
Practice Address - Country:US
Practice Address - Phone:201-797-8899
Practice Address - Fax:201-797-8484
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI030558001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice