Logan Alexander Wood, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901601718 Issued in MI

Practice address

932 Spring St Ste 102
Petoskey, MI 49770-2286

Phone

(231) 646-8005

NPI assigned

Jun 2, 2023

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1003509159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W LAKE ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702267",
            "telephone_number": "248-622-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 SPRING ST STE 102",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702286",
            "telephone_number": "231-646-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "LOGAN",
        "middle_name": "ALEXANDER",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901601718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael John Witten, RPH
• Brian D Wittenberg, M.D.
• Rebecca Woltman, NP-C
• Women'S Resource Center of Northern Michigan
• Adam Jens Wong, AU.D. CCC-A
• Patricia Geppert Woollcott, RN, CNM
• Kristin Noelle Wren, OTRL
• Wright & Filippis, Inc
• Wright & Filippis, Inc
• Alfred Joseph Wroblewski Jr., M.D.

• General Practice Dentistry in Petoskey, MI
• Providers in Petoskey, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.