Active NPI
Logan Brody Hall, DDS
- General Practice Dentistry
- Springdale, AR
National Provider Identifier
1417486192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4177
- Practice address
- 712 W Meadow Ave
Springdale, AR 72764-4462 - Phone
- (479) 751-4609
- NPI assigned
- Jun 7, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4177 | AR | Primary |
Addresses
Primary practice location
712 W Meadow Ave
Springdale, AR 72764-4462
Mailing address
152 N Oklahoma Way
Fayetteville, AR 72701-4445
Phone (479) 461-1804
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4177 | AR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Logan B Hall, DDS PLLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Springdale, AR
- NPI 1003424342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496793600000",
"number": "1417486192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 N OKLAHOMA WAY",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727014445",
"telephone_number": "479-461-1804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 W MEADOW AVE",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727644462",
"telephone_number": "479-751-4609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "LOGAN",
"middle_name": "BRODY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-07",
"last_updated": "2017-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "4177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.