NPIMap

Organization Active NPI

Logan H. Childers Jr. D.D.S. and Associates

  • Dentist
  • Independence, MO
National Provider Identifier
1164645438
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
011990 Issued in MO
Legal business name
LOGAN H. CHILDERS JR. D.D.S. AND ASSOCIATES
Practice address
12600 E US Highway 40
Independence, MO 64055-5955
Phone
(816) 478-4202
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Logan H Childers Jr., DDS
Title
Owner
Phone
(816) 478-4202

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 011990 MO Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 010648 MO

Addresses

Primary practice location

12600 E US Highway 40
Independence, MO 64055-5955

Mailing address

12600 E US Highway 40
Independence, MO 64055-5955
Phone (816) 478-4202

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1164645438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12600 E US HIGHWAY 40",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555955",
            "telephone_number": "816-478-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 E US HIGHWAY 40",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555955",
            "telephone_number": "816-478-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN H. CHILDERS JR. D.D.S. AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-478-4202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "011990",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "010648",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.