Individual provider Active NPI

Logan Renae Pennartz, DMD

  • General Practice Dentistry
  • Wichita Falls, TX
National Provider Identifier
1730006677
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42552 Issued in TX
Practice address
2211 Midwestern Pkwy Ste 5
Wichita Falls, TX 76308-2300
Phone
(940) 692-0321
NPI assigned
Jul 1, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 42552 TX Primary

Addresses

Primary practice location

2211 Midwestern Pkwy Ste 5
Wichita Falls, TX 76308-2300

Mailing address

2211 Midwestern Pkwy Ste 5
Wichita Falls, TX 76308-2300
Phone (940) 692-0321

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

NPI Registry JSON

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

{
    "created_epoch": "1782864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1730006677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 MIDWESTERN PKWY STE 5",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082300",
            "telephone_number": "940-692-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 MIDWESTERN PKWY STE 5",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082300",
            "telephone_number": "940-692-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNARTZ",
        "first_name": "LOGAN",
        "middle_name": "RENAE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-01",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "42552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.