Dr. Jack Capodice Jr., MD, DMD
Dr. Jack Capodice Jr. is a Oral and Maxillofacial Surgery (Dentist) provider (Dentist) practicing in Bloomington, IL, registered in the NPPES registry with NPI 1053397612 since 2005. The credential MD stands for Doctor of Medicine. Practices at Capodice, Efaw, Ocheltree & Elger Pllc (listed at the same practice address in NPPES).
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1053397612 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Dr. Jack Capodice Jr. |
| Credential | MD, DMD |
| Sex | Male |
| Practice address | 109 N REGENCY DR, Bloomington, IL, 61701 |
| Phone | 3096632526 |
| Fax | 3096634788 |
| Enumeration date | 2005-12-15 |
| Last updated in NPPES | 2026-04-06 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | Primary | 019022744 | IL |
MD — Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential
Copy-ready billing details
Provider: Jack Capodice, MD, DMD NPI: 1053397612 Taxonomy: 1223S0112X (Oral and Maxillofacial Surgery (Dentist)) Address: 109 N REGENCY DR, Bloomington, IL, 61701
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1710985759 | Capodice, Efaw, Ocheltree & Elger Pllc | Organization | Oral and Maxillofacial Surgery (Dentist) | Bloomington, IL |
| 1700862877 | David Efaw | Individual | Oral and Maxillofacial Surgery (Dentist) | Bloomington, IL |
| 1205892973 | Thomas Ocheltree | Individual | Oral and Maxillofacial Surgery (Dentist) | Bloomington, IL |
| 1114363579 | Anthony Elger | Individual | Oral and Maxillofacial Surgery (Dentist) | Bloomington, IL |
| 1750766358 | Taneenop Aramphongphan | Individual | Oral and Maxillofacial Surgery (Dentist) | Bloomington, IL |
Verify this record
Cross-check NPI 1053397612 against the authoritative CMS record: view Dr. Jack Capodice Jr. on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Where does Jack Capodice practice?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2026-04-06.