Provider Demographics
NPI:1992277958
Name:DAUPERT, DENNIS (PHD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:DAUPERT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6345 N MEADOW CIR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-4034
Mailing Address - Country:US
Mailing Address - Phone:317-388-1052
Mailing Address - Fax:
Practice Address - Street 1:6345 N MEADOW CIR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-4034
Practice Address - Country:US
Practice Address - Phone:317-370-2016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-31
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042900A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty