Active NPIIndividual providerSole proprietor

Logan Wilson, DMD

Dentist, Pediatric Dentistry in Pittsfield, Massachusetts

NPI Number1760062061
Practice location
77 Elm St, Pittsfield, MA 01201-6503
Fax
—
Last updated
July 11, 2023

Logan Wilson is a Dentist, Pediatric Dentistry based in Pittsfield, MA. Logan Wilson practices in Pittsfield, MA and has the professional credentials of DMD. The NPI Number for Logan Wilson is 1760062061 and holds a License No. DN1859678 (MA). The current practice location address for Logan Wilson is 77 Elm St, Pittsfield, MA 01201-6503 and can be reached out via phone at 413-442-0122.

Provider Profile Details

NPI Number
1760062061
Provider Name
Logan Wilson
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
77 Elm St, Pittsfield, MA 01201-6503
Phone Number
413-442-0122
Primary Taxonomy
Dentist, Pediatric Dentistry · 1223P0221X
Sole Proprietor
Yes
Provider Enumeration Date
April 11, 2021
Last Update Date
July 11, 2023
Certification Date
July 11, 2023
NPI Status
Active

Provider Business Practice Location Address Details

Address
77 Elm St
Pittsfield, MA 01201-6503
Zip
01201-6503
Phone Number
413-442-0122
Pittsfield, MA 01201Get directions →

Provider Business Mailing Address Details

Address
29 Westview RD
Lanesborough, MA 01237-9516
City
Lanesborough
State
MA
Zip
01237-9516
Phone Number
413-841-2094

License Information

License Number
DN1859678
License State
MA
Taxonomy
Dentist, Pediatric Dentistry · 1223P0221X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Logan Wilson, DMD?

The NPI number of Logan Wilson, DMD is 1760062061. It was assigned on April 11, 2021 and is currently active in the NPPES registry.

What is the specialty of Logan Wilson, DMD?

Logan Wilson, DMD is registered under the primary taxonomy Dentist, Pediatric Dentistry (code 1223P0221X), licensed in MA under license number DN1859678.

Where does Logan Wilson, DMD practice?

The practice location is 77 Elm St, Pittsfield, MA 01201-6503. The office can be reached at 413-442-0122 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1760062061 directly on the NPPES registry website.

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