Active NPI
Elizabeth Backus
- General Practice Dentistry
- Ashland, OR
National Provider Identifier
1760051510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D12171
- Practice address
- 1661 Siskiyou Blvd
Ashland, OR 97520-2470 - Phone
- (458) 246-1498
- NPI assigned
- Jun 24, 2021
- Last updated
- Aug 11, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12328611-9923 | UT | |
| General Practice Dentistry | 1223G0001X | DEN.00205221 | CO | |
| General Practice Dentistry | 1223G0001X | D12171 | OR | Primary |
Addresses
Primary practice location
1661 Siskiyou Blvd
Ashland, OR 97520-2470
Mailing address
2794 High Cedars LN
Medford, OR 97504-3416
Phone (626) 823-9070
Other practice location 1
4550 Broadway St Ste C-3E
Boulder, CO 80304-4801
Phone (303) 848-2906
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00205221 | CO | MD | General Practice Dentistry |
| D12171 | OR | MD | General Practice Dentistry |
| 12328611-9923 | UT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Boulder Dental Partners PLLP | General Practice | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Comfort Dental North Boulder
- General Practice Dentistry
- Boulder, CO
- NPI 1861246902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754870400000",
"number": "1760051510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2794 HIGH CEDARS LN",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975043416",
"telephone_number": "626-823-9070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1661 SISKIYOU BLVD",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975202470",
"telephone_number": "458-246-1498"
}
],
"practiceLocations": [
{
"address_1": "4550 Broadway St Ste C-3E",
"address_purpose": "LOCATION",
"city": "Boulder",
"state": "CO",
"postal_code": "803044801",
"country_code": "US",
"telephone_number": "303-848-2906",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BACKUS",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-24",
"last_updated": "2025-08-11",
"certification_date": "2025-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "12328611-9923",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "DEN.00205221",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D12171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.