Provider Demographics
NPI:1518372556
Name:JOHN D FERRIN DMD LLC
Entity Type:Organization
Organization Name:JOHN D FERRIN DMD LLC
Other - Org Name:ROGUE VALLEY PERIODONTICS AND IMPLANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FERRIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:541-944-5745
Mailing Address - Street 1:2930 E BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8309
Mailing Address - Country:US
Mailing Address - Phone:541-779-4501
Mailing Address - Fax:
Practice Address - Street 1:2930 E BARNETT RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8309
Practice Address - Country:US
Practice Address - Phone:541-779-4501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-28
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty