Individual
DR. JASON BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11 ROSSANLEY DR, MEDFORD, OR 97501-1713
(541) 797-6152
Mailing address
2794 HIGH CEDARS LN, MEDFORD, OR 97504-3416
(801) 245-0502
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12886440-9923
UT
1223G0001X
General Practice Dentistry
Primary
D12169
OR
1223G0001X
General Practice Dentistry
DEN.00205216
CO
Other
Enumeration date
06/08/2022
Last updated
10/01/2025
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