Logan Rand Curtis, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

058173 Issued in NY

Practice address

22632 Summit Dr Ste B
Watertown, NY 13601-7233

Phone

(315) 405-4005

NPI assigned

Aug 13, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Upstate Oral Surgery and Dental Implants, PLLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Watertown, NY
  • NPI 1952864548
  NPD (past) Authorized official

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1104131275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22632 SUMMIT DR STE B",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136017233",
            "telephone_number": "315-405-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22632 SUMMIT DR STE B",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136017233",
            "telephone_number": "315-405-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CURTIS",
        "first_name": "LOGAN",
        "middle_name": "RAND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-13",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "7737284-9921",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "058173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Cummings
• Cynthia Marie Cuppernell, MS
• Tasha Lynne Curry, FNP
• Brenda Lee Curtis, OTR
• Dawn Marie Curtis, LCSW
• Paul S Curtis, MD
• CVS Albany LLC
• Cynthia Maguire, PSYD
• Natale Dabulewicz
• Jarus Dahlberg

• All providers in Watertown, NY
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.