Logan West Sardzinski, DDS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

DDS-09820 Issued in IA

Practice address

200 Hawkins Dr
Iowa City, IA 52242-1049

Phone

(319) 356-2205

Fax

(319) 356-8956

NPI assigned

Aug 28, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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.

• State University of Iowa

  dba University of Iowa Health Care

  • Family Medicine Physician
  • Iowa City, IA
  • NPI 1477554814
  Medicare reassignment NPD
• State University of Iowa

  dba College of Dentistry

  • Dentist
  • Iowa City, IA
  • NPI 1609956234
  NPD
• State University of Iowa

  • Clinical Medical Laboratory
  • Coralville, IA
  • NPI 1851371561
  NPD (past)

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1902419070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51300 POMERANTZ FAMILY PAVILION",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421049",
            "telephone_number": "319-356-2205",
            "fax_number": "319-335-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421049",
            "telephone_number": "319-356-2205",
            "fax_number": "319-356-8956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Newton Rd.",
            "address_2": "Dental Science Building",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421001",
            "country_code": "US",
            "telephone_number": "319-335-7499",
            "fax_number": "319-335-7451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 E Campus Loop S",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685831530",
            "country_code": "US",
            "telephone_number": "402-472-1320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SARDZINSKI",
        "first_name": "LOGAN",
        "middle_name": "WEST",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "09820",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IA",
            "license": "09820",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": "DDS-09820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark K Santillan, M.D.
• Ann Marie Santos, PH.D.
• William Clarence Santos, M.D.
• Michael L Santucci, D.D.S.
• Sakditad Saowapa, MD
• Salaish K Sarin, M.D.
• Lea Sarment, DDS
• Esteban Alejandro Sarmentera Conway, M.D.
• Emily A Sarvis, PA
• Kaoru Sasaka, MD

• Student in an Organized Health Care Education/Training Program in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Student in an Organized Health Care Education/Training Program in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.