IndividualActive
Chloe Boucher
NPI 1265151112 · Periodontics · Jacksonville, FL
Provider details
- NPI number
- 1265151112
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Sex
- Female
- Sole proprietor
- No
- License
- DN28865 (FL)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3990 San Jose Park Dr
Jacksonville, FL 32217-4613
Phone: (904) 731-1324
Street-level locationGet directions
Mailing address
1 Riverside Ave Apt 3520
Jacksonville, FL 32202-5156
Registry dates
- Enumerated
- 2022-08-24
- Last updated
- 2025-10-01
- Certified
- 2025-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.