Jason Backus, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12169 Issued in OR

Practice address

11 Rossanley Dr
Medford, OR 97501-1713

Phone

(541) 797-6152

NPI assigned

Jun 8, 2022

Last updated

Oct 1, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jason Pruett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1770212409",
    "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": "801-245-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ROSSANLEY DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975011713",
            "telephone_number": "541-797-6152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKUS",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "12886440-9923",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00205216",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D12169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASON",
            "last_name": "PRUETT",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Babek, PT
• Sara Beth Babek, O.D.
• Toni Anne Baca, FNP
• Andrew M Bacha IV, DPT
• Rachel Bachman
• Natalie Bacon
• Christia Bactista
• Arianna Badizadegan, M.S.
• Melodee Kay Badley, FNP
• Philip C Baehmann, R.PH.

• General Practice Dentistry in Medford, OR
• Providers in Medford, 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 Oct 1, 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.

Verify at the official NPI Registry.