Logan Oral Surgery

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

8227102-9924 Issued in UT

Legal business name

LOGAN ORAL SURGERY

Practice address

3125 N. Main Street
Ste #103
North Logan, UT 84341-1550

Phone

(435) 754-7130

Fax

(435) 535-2464

NPI assigned

May 15, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Scott Matson, D.M.D.

Title

Owner

Phone

(435) 754-7130

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1598024341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 N. MAIN STREET",
            "address_2": "STE #103",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411550",
            "telephone_number": "435-754-7130",
            "fax_number": "435-535-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 N. MAIN STREET",
            "address_2": "STE #103",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411550",
            "telephone_number": "435-754-7130",
            "fax_number": "435-535-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "MATSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-754-7130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "8227102-9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Gasser Jordan, FNP
• Nina G Jorgensen, M.D.
• Barrett Paul Labrum, D.O.
• Lifetech Consulting
• Logan Medical Group LLC
• Low T Clinic, LLC
• Gregg R Luke, R.PH.
• Tanner Sean Lyons, DPT
• Scott Macdonald, PA-C
• Maple Springs Management, LLC

• Oral and Maxillofacial Surgery Clinic/Center in North Logan, UT
• Providers in North Logan, UT by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.