Logan Keith Connor, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D15116 Issued in MN

Practice address

5831 Brooklyn Blvd
Brooklyn Center, MN 55429-2521

Phone

(763) 533-8669

NPI assigned

Jun 18, 2024

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.

• Brooklyn Blvd. Dental

  • Health Maintenance Organization
  • Brooklyn Center, MN
  • NPI 1932373032
  NPD (past)
• Don Blakeslee DDS PA

  • Dentist
  • Blaine, MN
  • NPI 1194949511
  NPD (past)
• University Ave Dental, PLLC

  • General Practice Dentistry
  • Blaine, MN
  • NPI 1093468852
  NPD (past)

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1043053796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7051 DA MAR EST",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560829431",
            "telephone_number": "507-995-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5831 BROOKLYN BLVD",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554292521",
            "telephone_number": "763-533-8669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10155 University Ave NE Ste 112",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554348058",
            "country_code": "US",
            "telephone_number": "763-784-1242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "LOGAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D15116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Care Chiropractic @ Rehab Center, LLC
• Community Outreach Services LLC
• Companion Health Services, LLC
• Compassionate Healthcare LLC
• Concierge Healthcare
• Jemima Conteh
• James Contois
• Parker William Cook
• Sara Jean Cooper, D.D.S
• Covenant Care, LLC

• General Practice Dentistry in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.