Logan Williams, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.026132 Issued in OH

Practice address

8435 Station St
Mentor, OH 44060-4924

Phone

(440) 255-3111

NPI assigned

May 19, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Lake Dental Arts

  • Dentist
  • Mentor, OH
  • NPI 1497147219
  NPD (past)

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1003439530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6151 CUMBERLAND CT",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440602448",
            "telephone_number": "419-308-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8435 STATION ST",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604924",
            "telephone_number": "440-255-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LOGAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathon Williams, QMHS
• Kara Patlynn Williams
• Kathleen Denise Williams
• La-Angel Starr Williams
• Laura Williams
• Maggie Williams
• Shardae Williams
• Simona N Williams, CDCA
• Lindsay N Williamson, ATC
• Mandy Lynne Willis, PT

• General Practice Dentistry in Mentor, OH
• Providers in Mentor, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.