Logan Mackey Fox, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-5640 Issued in ID

Practice address

1097 N Jacksonmill Ave
Kuna, ID 83634-2086

Phone

(208) 519-7171

NPI assigned

Jun 24, 2024

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Idaho Dental Professionals, P.C.

  • General Practice Dentistry
  • Kuna, ID
  • NPI 1366135857

  General Practice

  NPD

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1861236747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N KATIE WAY",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836342161",
            "telephone_number": "971-203-3896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1097 N JACKSONMILL AVE",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836342086",
            "telephone_number": "208-519-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "LOGAN",
        "middle_name": "MACKEY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-5640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Ann Eyolfson, PA
• Falcon Ridge Public Charter School
• Erin Fischer, LPC
• Donna Gail Flood, PTA AAS
• Michael W Foutz, MD
• Grant H Francis, DDS
• Michelle Catherine Frenger
• Margaret Anne Fry Lawson, C-PNP
• Full Circle Health, Inc.
• Sarah G. Gerrish, M.D.

• All providers in Kuna, ID
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.