Active NPI
Logan Louque, DDS
- Dentist
- Chapin, SC
National Provider Identifier
1790521409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DGD.10861
- Practice address
- 1221 Chapin Rd Ste a
Chapin, SC 29036-7142 - Phone
- (803) 994-8188
- NPI assigned
- Jul 2, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DGD.10861 | SC | Primary |
Addresses
Primary practice location
1221 Chapin Rd Ste a
Chapin, SC 29036-7142
Mailing address
2211 Trade St
West Columbia, SC 29169-7683
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 |
|---|---|---|---|
| DGD.10861 | SC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chapin Smiles Dentistry, PC | Dentist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1790521409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2211 TRADE ST",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291697683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 CHAPIN RD STE A",
"city": "CHAPIN",
"state": "SC",
"postal_code": "290367142",
"telephone_number": "803-994-8188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOUQUE",
"first_name": "LOGAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-02",
"last_updated": "2024-07-02",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "SC",
"license": "DGD.10861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chapin, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.