Logan Autry Cumbaa, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN123787 Issued in GA

Practice address

1215 Vine St NE
Gainesville, GA 30501-2535

Phone

(770) 532-4555

NPI assigned

Jun 3, 2025

Last updated

Jun 6, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Georgia Dental Group

  dba BGW Dental Group

  • General Practice Dentistry
  • Braselton, GA
  • NPI 1063904076
  NPD (past)

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1841184199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 DUE SOUTH RD",
            "city": "WHIGHAM",
            "state": "GA",
            "postal_code": "398974032",
            "telephone_number": "229-289-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 VINE ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012535",
            "telephone_number": "770-532-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMBAA",
        "first_name": "LOGAN",
        "middle_name": "AUTRY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Ann Crudgington, MD
• Christopher Crumley, PA
• Juan Carlos Cruz Alzate, DDS
• Inna Cubara, MD
• Liza Cuevas
• Kasey Leann Currie
• Chase Alain Czaykowsky, MD
• D H Stanley Pharmacy Services Corp (McElveen's Pharmacy)
• Leesa Ann Dabbs, D.C.
• Folashade Dada, AGACNP

• General Practice Dentistry in Gainesville, GA
• Providers in Gainesville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; 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.