DR. DARREN B. RAVASSIPOUR (NPI# 1215042122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215042122 |
| Entity Type | Individual |
| Full Name | DR. DARREN B. RAVASSIPOUR |
| Credential | D.D.S., M.S., PC |
| Practice Address |
3180 State St Ste 102 Medford OR 97504-8493 |
| Practice Telephone | 5417796200 |
| Practice Fax Number | 5417796203 |
| Mailing Telephone | 5417796200 |
| Mailing Fax Number | 5417796203 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
D8177 | OR | Dental Providers |
| Street Address |
3180 STATE ST STE 102 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-8493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003381914 | Keyan Botsford | Dentist | 1625 E Mcandrews Rd Ste B, Medford, OR 97504-5334 | 2018-10-06 |
| 1184939621 | Megan Janee Baker | Dentist | 1429 Center Dr Ste 104, Medford, OR 97501-7993 | 2010-08-09 |
| 1235259417 | Joy Elizabeth Kasparian Federico | Dentist | 80 High Street, Suite #2, Medford, MA 02155 | 2007-03-30 |
| 1760509756 | Edwin Wridge Bennion | Dentist | 725 Golf View Dr, Medford, OR 97504-9643 | 2007-03-23 |
| 1679607105 | Leon S Klempner | Dentist | 1645 Route 112 Ste B, Medford, NY 11763-3635 | 2007-03-15 |
| 1265445647 | David A. Wang | Dentist | 537 Murphy Rd, Suite B, Medford, OR 97504-8187 | 2006-08-15 |
| 1740209832 | Edward V. Shagam | Dentist | 686 Stokes Rd, Medford, NJ 08055-2909 | 2006-07-19 |
| 1316915788 | David M. Petrarca, Dds & Sungyon Bang, Dmd, P.C. | Dentist | 80 High St, Medford, MA 02155-3813 | 2006-03-10 |
| 1295726388 | Barry M Katzen | Dentist | 2937 Siskiyou Blvd, Medford, OR 97504-8100 | 2005-10-29 |
| 1194721795 | Eric R Gheewalla | Dentist | 82 Forest St, Medford, MA 02155-3130 | 2005-06-28 |
| Find all providers in MEDFORD | ||||
Please comment or provide details below to improve the information on DR. DARREN B. RAVASSIPOUR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.