NPIMap

Organization Active NPI

Logan Dental Assoicates

  • General Practice Dentistry
  • Logan, UT
National Provider Identifier
1477658151
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LOGAN DENTAL ASSOICATES
Practice address
40 W. Cache Valley Blvd
Suite 2a
Logan, UT 84341
Phone
(435) 787-8207
Fax
(435) 787-8253
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paul Edward Harris, DDSNPI 1124107586
Title
Owner / Dentist
Phone
(435) 787-8207

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

40 W. Cache Valley Blvd
Suite 2a
Logan, UT 84341

Mailing address

40 W. Cache Valley Blvd
Suite 2a
Logan, UT 84341
Phone (435) 787-8207

National Provider Directory

National Provider Directory

Locations

40 W Cache Valley Blvd
Ste 2A
Logan, UT 84341
Phone (435) 787-8207

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477658151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W. CACHE VALLEY BLVD",
            "address_2": "SUITE 2A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "84341",
            "telephone_number": "435-787-8207",
            "fax_number": "435-787-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W. CACHE VALLEY BLVD",
            "address_2": "SUITE 2A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "84341",
            "telephone_number": "435-787-8207",
            "fax_number": "435-787-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN DENTAL ASSOICATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER / DENTIST",
        "authorized_official_telephone_number": "435-787-8207",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.