Logan Reilly, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

03795 Issued in NH

Practice address

74 S Main St
Rochester, NH 03867-2708

Phone

(603) 332-5429

Fax

(603) 332-6641

NPI assigned

Jul 22, 2010

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

Enrolled in NH

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

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1982917696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 S MAIN ST",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038672708",
            "telephone_number": "603-332-5429",
            "fax_number": "603-332-6641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 S MAIN ST",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038672708",
            "telephone_number": "603-332-5429",
            "fax_number": "603-332-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "LOGAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "03795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Red Bird OT Services, LLC
• Deepa Reddy Batapati Krishna, DMD, FAGD
• Jessica Tatum Regan, CF-SLP
• Susan Reid
• Ashley Marie Reilly
• Natalia Resor, BCBA
• Richard M. Farina DMD
• Richard M. Farina, D.M.D.,PC
• Kea Rief
• Jillian Riendeau, MSW

• Dentist in Rochester, NH
• Providers in Rochester, NH by specialty
• Dentist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.