NPIMap

Individual provider Active NPI

Hugh David Logan III, DDS

  • General Practice Dentistry
  • Fort Eustis, VA
National Provider Identifier
1942218508
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS021700L Issued in PA
Practice address
577 Sternberg Ave
Fort Eustis, VA 23604-1526
Phone
(757) 314-7944
Fax
(757) 314-7942
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS021700L PA Primary

Addresses

Primary practice location

577 Sternberg Ave
Fort Eustis, VA 23604-1526

Mailing address

577 Sternberg Ave
Fort Eustis, VA 23604-1526
Phone (757) 314-7944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS021700LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
HQ US Army Dental Activities Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1942218508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 STERNBERG AVE",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236041526",
            "telephone_number": "757-314-7944",
            "fax_number": "757-314-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 STERNBERG AVE",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236041526",
            "telephone_number": "757-314-7944",
            "fax_number": "757-314-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "HUGH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS021700L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Eustis, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.