Rogue Valley Oral & Maxillofacial Surgery, PC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

D9230 Issued in OR

Legal business name

ROGUE VALLEY ORAL & MAXILLOFACIAL SURGERY, PC

Practice address

460 Murphy Road
Medford, OR 97504

Phone

(541) 776-0050

Fax

(541) 776-0062

NPI assigned

Aug 27, 2009

Last updated

Mar 26, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael J. Doherty, DDS, FACSNPI 1386634418

Title

Surgeon/President

Phone

(541) 776-0050

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael J Doherty, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Medford, OR
  • NPI 1386634418
  Authorized official Same address or phone

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585180800000",
    "number": "1699908475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 MURPHY ROAD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-776-0050",
            "fax_number": "541-776-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 MURPHY ROAD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-776-0050",
            "fax_number": "541-776-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGUE VALLEY ORAL & MAXILLOFACIAL SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "SURGEON/PRESIDENT",
        "authorized_official_telephone_number": "541-776-0050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, FACS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D9230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rogue Valley Physicians

• Oral and Maxillofacial Surgery Clinic/Center in Medford, OR
• Providers in Medford, OR by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.