Provider Demographics
NPI:1225287899
Name:J2 DENTISTRY LLC
Entity Type:Organization
Organization Name:J2 DENTISTRY LLC
Other - Org Name:CENTRAL OREGON PEDIATRIC DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:541-686-2446
Mailing Address - Street 1:PO BOX 7283
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-0012
Mailing Address - Country:US
Mailing Address - Phone:541-686-2446
Mailing Address - Fax:541-686-3055
Practice Address - Street 1:850 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2751
Practice Address - Country:US
Practice Address - Phone:541-923-8666
Practice Address - Fax:541-923-1967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty