Provider Demographics
NPI:1588098917
Name:ADAMS, JARED R (DDS)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:R
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 NE FRANKLIN AVE BLDG D
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4917
Mailing Address - Country:US
Mailing Address - Phone:541-382-5678
Mailing Address - Fax:541-382-8327
Practice Address - Street 1:361 NE FRANKLIN AVE BLDG D
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4917
Practice Address - Country:US
Practice Address - Phone:541-382-1279
Practice Address - Fax:541-382-8327
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK15101223G0001X
ORD104311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice