Logan Cornwell, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010936 Issued in AZ

Practice address

1025 S Power Rd Ste 106
Mesa, AZ 85206-5240

Phone

(480) 386-9111

NPI assigned

May 19, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1790308286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S POWER RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065240",
            "telephone_number": "480-386-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S POWER RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065240",
            "telephone_number": "480-386-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWELL",
        "first_name": "LOGAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-19",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00204475",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornerstone Medical Implants, PLC
• Cornerstone Pain Management LLC
• Cornerstone Physical Medicine, LLC
• Cornerstone Wellness Center LLC
• Kayla M Cornett
• Michelle Marie Cornwell, PT
• Bianca Louise Corona
• Brigitte Coronado, MA, BCBA, LBA
• Kirstin Anna Correia, N.D.
• Susan Rose Cortesi, M.D.

• General Practice Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.