Logan Nalley Jr., D.M.D.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

8956 Issued in GA

Practice address

3643 Walton Way Ext
Augusta, GA 30909-4507

Phone

(706) 733-8641

Fax

(706) 733-8615

NPI assigned

Mar 12, 2007

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235261272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3643 WALTON WAY EXT",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094507",
            "telephone_number": "706-733-8641",
            "fax_number": "706-733-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 WALTON WAY EXT",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094507",
            "telephone_number": "706-733-8641",
            "fax_number": "706-733-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLEY",
        "first_name": "LOGAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "8956",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "SC",
            "license": "2237",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kanak Naidu, M.D.
• Yasaman Najafi-Walker
• Amjad Najim, M.D.
• Ivy L. Nalley, LCSW, CAADC
• Logan Nalley III, DMD
• Farnaz Namazi, DDS
• Payal Nanda, M.D.
• Srijita Nandy
• George Tomy Naratadam
• Kashif Naseem, MD

• Prosthodontics in Augusta, GA
• Providers in Augusta, GA by specialty
• Prosthodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.