Jennifer L Logigian, DMD, MPH

Primary specialty

DentistTaxonomy code 122300000X

License

DT2590 Issued in HI

Practice address

74-5214 Keanalehu Dr
Kailua Kona, HI 96740

Phone

(808) 355-5650

NPI assigned

Jun 27, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

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": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1174963755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY STE 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401753",
            "telephone_number": "808-326-5629",
            "fax_number": "808-329-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74-5214 KEANALEHU DR",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "96740",
            "telephone_number": "808-355-5650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 Prairie Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029051924",
            "country_code": "US",
            "telephone_number": "401-444-0430",
            "fax_number": "401-444-0489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGIGIAN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL11902",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016.0101814",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "DEN03355",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT2590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Dentist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.