Temicka Logan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS0000010434 Issued in TN

Practice address

1037 W Main St Ste E
Lebanon, TN 37087-3356

Phone

(615) 444-2262

NPI assigned

Apr 29, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Temicka Terrell Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: temicka.logandds.p1@direct.mwchc.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Matthew Walker Comprehensive Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Nashville, TN
  • NPI 1356405278
  Medicare reassignment NPD
• Matthew Walker Comprehensive Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Clarksville, TN
  • NPI 1104008747
  NPD

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1235584913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 DR DB TODD JR BLVD",
            "address_2": "MEHARRY MEDICAL COLLEGE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372083501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 W MAIN ST STE E",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873356",
            "telephone_number": "615-444-2262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Dr Db Todd Jr Blvd",
            "address_2": "Meharry Medical College",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372083501",
            "country_code": "US",
            "telephone_number": "615-327-6669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "TEMICKA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS0000010434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TEMICKA",
            "last_name": "TERRELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Francisco Andres Llado Rodriguez, MD, PHARMD
• Loeco LLC
• Troy L. Long III, D.D.S.
• Longevity Psychiatric Health & Wellness,LLC
• Esther Lorenzo
• Rachel W. Low, RN
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• General Practice Dentistry in Lebanon, TN
• Providers in Lebanon, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.