LEGENDARY DENTAL PLLC (NPI# 1114490778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114490778 |
| Entity Type | Organization |
| Organization Name | LEGENDARY DENTAL PLLC |
| Practice Address |
1809 21st St Harlan IA 51537-1828 |
| Practice Telephone | 7123400333 |
| Mailing Telephone | 7123400333 |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2019-01-07 |
| Authorized Official Name | DR. LOGAN TRAVIS VEATH (DENTIST/OWNER) |
| Authorized Official Telephone | 7123400333 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1366821183 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | LEGENDARY DENTAL PLLC | 2329 700th Street, Elk Horn, IA 51531 |
| Street Address |
1809 21ST ST |
| City | HARLAN |
| State | IA |
| Zip Code | 51537-1828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063925097 | Morningview Dental, Pllc | Dentist | 1116 Morningview Dr., Harlan, IA 51537 | 2017-11-13 |
| 1992133292 | Frances B. Hutson | Dietitian, Registered | 2003 Chatburn Ave., Hy-vee, Harlan, IA 51537 | 2013-10-23 |
| 1043449168 | Edith H Shetler | Speech-Language Pathologist | 1213 Garlfied Ave, Harlan, IA 51537 | 2009-07-10 |
| 1114086287 | Heartland Family Service | Clinic/Center | 1710 Industrial Pkwy, Harlan, IA 51537 | 2006-12-06 |
| 1356457535 | Phillip Lynn Markham | Dentist | 2105 Pine St, Harlan, IA 51537 | 2006-08-21 |
| 1831114255 | Concerned, Inc. | Day Training, Developmentally Disabled Services | 1802 Industrial Parkway, Harlan, IA 51537 | 2006-07-13 |
| 1457323198 | Michael R Rosmann | Psychologist | 1210 7th St, Ste C Michael R Rosmann Phd, Harlan, IA 51537 | 2006-02-06 |
| 1912982075 | Bret D. Heileson | Emergency Medicine | 1220 Chatburn Avenue, Harlan, IA 51537 | 2005-12-13 |
| 1821468547 | Swfac | Podiatrist | 1213 Garfield Ave, Harlan, IA 51537 | 2015-10-07 |
| 1043443260 | White Pine Dental Group Pllc | Dentist | 2105 Pine St, Harlan, IA 51537 | 2009-09-04 |
| Find all providers in zip 51537 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063925097 | Morningview Dental, Pllc | Dentist | 1116 Morningview Dr., Harlan, IA 51537 | 2017-11-13 |
| 1356457535 | Phillip Lynn Markham | Dentist | 2105 Pine St, Harlan, IA 51537 | 2006-08-21 |
| 1053302950 | Stephen Paul Allen | Dentist | 1407 Garfield Ave, Harlan, IA 51537-1822 | 2005-10-31 |
| 1881210714 | Kaitlyn Skidmore Patel | Dentist | 301 E Central St, Harlan, KY 40831-2303 | 2020-06-16 |
| 1811469851 | Markham Family Dental Associates, Inc. | Dentist | 2105 Pine St, Harlan, IA 51537-1898 | 2018-12-31 |
| 1780114447 | Mary Hoch | Dentist | 2105 Pine St, Harlan, IA 51537-1850 | 2017-06-15 |
| 1043443260 | White Pine Dental Group Pllc | Dentist | 2105 Pine St, Harlan, IA 51537 | 2009-09-04 |
| 1225293582 | Earl E. Boltinghouse | Dentist | 2105 Pine St, Harlan, IA 51537-1850 | 2008-07-25 |
| 1457558082 | Clint Brandon Mcqueen | Dentist | 118 S 1st St, Harlan, KY 40831-2318 | 2007-06-28 |
| 1043371008 | Stephen C Bryson | Dentist | 110 Professional Ln, Suite 201, Harlan, KY 40831-2590 | 2006-12-13 |
| Find all providers in HARLAN | ||||
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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.