Logan White, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901021968 Issued in MI

Practice address

2215 Fuller Road
Vamc Dental Service (160)
Ann Arbor, MI 48105-9923

Phone

(734) 845-3528

NPI assigned

Jul 11, 2016

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1922450212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 FULLER ROAD",
            "address_2": "VAMC DENTAL SERVICE (160)",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059923",
            "telephone_number": "734-845-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 FULLER ROAD",
            "address_2": "VAMC DENTAL SERVICE (160)",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059923",
            "telephone_number": "734-845-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "LOGAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Robert White II, MD
• Kaitlyn Elizabeth White, CD (DONA)
• Katherine Rose White, MD
• Lauren Alaine White, MPH, MSW
• Lauren Alexis White, M.A., LPC
• Lucas Joe Alexander White, LLMSW
• Marie White, LLMSW
• Mark S White, PA
• Michaela Ngaire White
• Michele White, PHD LLP LPC

• Dentist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.