NORTH LOGAN PDC PLLC (NPI# 1649837337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649837337 |
| Entity Type | Organization |
| Organization Name | NORTH LOGAN PDC PLLC |
| Practice Address |
1445 N 400 E Ste 3a Logan UT 84341-7564 |
| Mailing Address |
Po Box 970184 Orem UT 84097-0309 |
| Practice Telephone | 4357521699 |
| Mailing Telephone | 9013053460 |
| Mailing Fax Number | 8013356551 |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |
| Authorized Official Name | JACOB WARNER (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 8016911701 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers | ||
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Platinum Dental Care | Doing Business As Name - Organization |
| Street Address |
1445 N 400 E STE 3A |
| City | LOGAN |
| State | UT |
| Zip Code | 84341-7564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1043702046 | Eye Pros of Logan LLC | Optometrist | 1475 N Main St Ste 103, Logan, UT 84341 | 2018-06-05 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| Find all providers in zip 84341 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821589516 | Sleep Well Idaho LLC | Dentist | 199 Quail Hollow Rd, Logan, UT 84321-6750 | 2018-05-29 |
| 1417211350 | Jeffrey David Wegener | Dentist | 1451 N 200 E Ste 200, Logan, UT 84341-7565 | 2012-06-26 |
| 1891073334 | Jake Daniel Sorensen | Dentist | 40 W. Cache Valley Blvd. #2a, Logan, UT 84341 | 2011-08-02 |
| 1427343359 | Brian Daniel Boston | Dentist | 1320 N 600 E Ste 1, Logan, UT 84341-2474 | 2011-06-20 |
| 1366698870 | M. Andrew Johnson | Dentist | 41 E 400 N, #338, Logan, UT 84321-4020 | 2008-08-15 |
| 1881858637 | Lisa Jan Haddox-heston | Dentist | 1 Wildcat Way, Logan, WV 25601-3474 | 2008-07-10 |
| 1194983502 | Andrew C Olson | Dentist | 167 E 200 N Ste 6, Logan, UT 84321-4049 | 2008-06-02 |
| 1699988790 | Brent Wayne Gray | Dentist | 1445 N 400 E Ste 2, Logan, UT 84341-7564 | 2007-05-07 |
| 1750392833 | Brett T Skinner | Dentist | 150 E 200 N, Ste E, Logan, UT 84321 | 2006-08-11 |
| 1497764971 | Joseph P Blanch | Dentist | 167 E 200 N, Ste 6, Logan, UT 84321 | 2006-08-05 |
| Find all providers in LOGAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.