Jonathan E Backer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7805 Issued in OR

Practice address

1551 E Main St
Cottage Grove, OR 97424-2241

Phone

(541) 942-8437

Fax

(541) 942-1350

NPI assigned

Nov 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1477629046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 E MAIN ST",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974242241",
            "telephone_number": "541-942-8437",
            "fax_number": "541-942-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 E MAIN ST",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974242241",
            "telephone_number": "541-942-8437",
            "fax_number": "541-942-1350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 E 10th Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974013304",
            "country_code": "US",
            "telephone_number": "541-344-3333",
            "fax_number": "541-683-3999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACKER",
        "first_name": "JONATHAN",
        "middle_name": "E",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D7805",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aspen Injury Center LLC
• Aspen Injury Center LLC
• Aspen Injury Center LLC
• Chelsey Rose Augustyniak
• Samantha Rae Ayala, DMD
• Chelsea Badolian, LMT
• Heidi Kim Baer-Postigo
• Linda S Bailey, RDH
• Sarah Marie Baker
• Larry D Barkemeyer

• General Practice Dentistry in Cottage Grove, OR
• Providers in Cottage Grove, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.