Logan Conrad Smith, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901021197 Issued in MI

Practice address

7706 Georgetown Center Dr Ste a
Jenison, MI 49428-7145

Phone

(616) 855-0005

Fax

(616) 855-0048

NPI assigned

Jun 5, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Logan C Smith DDS PLLC

  • General Practice Dentistry
  • Jenison, MI
  • NPI 1649803388
  NPD Authorized official

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1821401068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7706 GEORGETOWN CENTER DR STE A",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287145",
            "telephone_number": "616-855-0005",
            "fax_number": "616-855-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7706 GEORGETOWN CENTER DR STE A",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287145",
            "telephone_number": "616-855-0005",
            "fax_number": "616-855-0048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2340 Marwood Dr",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "MI",
            "postal_code": "483281633",
            "country_code": "US",
            "telephone_number": "248-933-2389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LOGAN",
        "middle_name": "CONRAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-05",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Simpson
• Colleen Skuza, M.A., CF-SLP
• Gracen Loraine Smit, LLPC
• Allen Ralph Smith, O.D.
• Heather Lyn-Nieboer Smith, ATC
• Natalie Smith
• Scott Edward Sorensen, R.PH.
• Space for Change Therapeutic Services, LLC
• Megan Spangler
• Susan Spears, LMSW

• Dentist in Jenison, MI
• Providers in Jenison, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.