Shaun Logan, DMD is a medicare enrolled "Dentist - General Practice" provider in Ranchester, Wyoming. His current practice location is
621 Dayton Street, Ranchester, Wyoming. You can reach out to his office (for appointments etc.) via phone at
(307) 655-9810.
Shaun Logan is licensed to practice in Wyoming (license number 1407) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1144603812.
Healthcare Provider's Profile
Full Name | Shaun Logan |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 621 Dayton Street, Ranchester, Wyoming |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1144603812
- Provider Enumeration Date: 06/30/2015
- Last Update Date: 06/30/2015
Medicare PECOS Information:
- PECOS PAC ID: 1850682048
- Enrollment ID: I20160617001853
Medical Identifiers
Medical identifiers for Shaun Logan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1144603812 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 1407 (Wyoming) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shaun Logan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Shaun Logan, DMD 621 Dayton Street, Ranchester, WY 82839 Ph: (307) 655-9810 | Shaun Logan, DMD 621 Dayton Street, Ranchester, WY 82839 Ph: (307) 655-9810 |
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