NPIMap

Organization Active NPI

Jacob J Foutz DMD, LLC

  • Dental Clinic/Center
  • Medford, OR
National Provider Identifier
1326537143
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D10292 Issued in OR
Legal business name
JACOB J FOUTZ DMD, LLC
Practice address
806 E Jackson St
Medford, OR 97504-6773
Phone
(541) 734-5225
NPI assigned
May 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jacob Foutz, DMDNPI 1912381856
Title
Dentist
Phone
(541) 734-5225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D10292 OR Primary

Addresses

Primary practice location

806 E Jackson St
Medford, OR 97504-6773

Mailing address

806 E Jackson St
Medford, OR 97504-6773
Phone (541) 734-5225

National Provider Directory

National Provider Directory

Locations

806 E Jackson St
Medford, OR 97504
Phone (541) 734-5225

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1326537143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046773",
            "telephone_number": "541-734-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046773",
            "telephone_number": "541-734-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB J FOUTZ DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "FOUTZ",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "541-734-5225",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D10292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.