Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

THEODORE E LOGAN JR. DMD
NPI 1245231778
Dentist - Oral and Maxillofacial Surgery in Louisville, KY

Q: What is Theodore Logan's NPI number?

The NPI number for Theodore Logan is 1245231778. It was assigned to this individual provider in the NPPES registry on August 9, 2005.

Q: What is Theodore Logan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for Theodore Logan was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 36 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 09, 2005

3101 BRECKENRIDGE LN, STE 2D, LOUISVILLE, KY 40220(502) 459-8012(502) 459-8021 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Theodore E Logan Jr. Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE E LOGAN JR. DMD (NPI 1245231778) is an individual oral and maxillofacial surgery provider in Louisville, Kentucky, licensed in Kentucky (4056) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1245231778

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameTHEODORE E LOGAN JR.Credential: DMD

Location Address3101 BRECKENRIDGE LN, STE 2DLouisville, KY 40220-2742

Mailing Address3101 Breckenridge Ln, Ste 2dLouisville, KY 40220-2742 · (502) 459-8012 · Fax (502) 459-8021

Phone(502) 459-8012

Fax(502) 459-8021

Sole ProprietorNo

Enumeration DateAugust 9, 2005

Last NPPES UpdateJuly 13, 2026

✔ NPI 1245231778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in KY · 4056

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

3101 BRECKENRIDGE LN, Louisville, KY 40220

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Other Identifiers 3

Medicaid64040561KY

Other1055007KY · Passport

Other60040565KY · Medicaid Dental

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HERSHEL WEINBERG DDS

Dentist (General Practice)

3101 BRECKENRIDGE LN, SUITE 2A
LOUISVILLE, KY 40220

Jefferson County (502) 451-5222

RICHARD A PAPE DMD MS

Dentist (Oral and Maxillofacial Surgery)

3101 BRECKENRIDGE LN, STE 2D
LOUISVILLE, KY 40220

Jefferson County (502) 459-8012

MYRON F SHUSTER, DMD

Dentist (Pediatric Dentistry)

3101 BRECKENRIDGE LN, SUITE 4B
LOUISVILLE, KY 40220

Jefferson County (502) 451-1020

JULIE M HARRIS DMD

Dentist (Oral and Maxillofacial Surgery)

3101 BRECKENRIDGE LN, STE 2D
LOUISVILLE, KY 40220

Jefferson County (502) 459-8012

ANESTHESIOLOGY ASSOCIATES PSC

Anesthesiology

3101 BRECKENRIDGE LN, SUITE 1A
LOUISVILLE, KY 40220

Jefferson County (502) 458-7400

ALDIS E NORGELLO CRNA

Nurse Anesthetist, Certified Registered

3101 BRECKENRIDGE LN, SUITE 1A
LOUISVILLE, KY 40220

Jefferson County (502) 458-7400

JOAN M DEENER CRNA

Nurse Anesthetist, Certified Registered

3101 BRECKENRIDGE LN, SUITE 1A
LOUISVILLE, KY 40220

Jefferson County (502) 458-7400

LOUISVILLE INTERNAL MEDICINE & PEDIATRICS, LLC

Internal Medicine

3101 BRECKENRIDGE LN, #4E
LOUISVILLE, KY 40220

Jefferson County (502) 454-5252

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Logan's NPI number?

The NPI number for Theodore Logan is 1245231778. It was assigned to this individual provider in the NPPES registry on August 9, 2005.

Where is Theodore Logan located?

Theodore Logan practices at 3101 Breckenridge Ln Ste 2D, Louisville, KY 40220. The listed phone number is (502) 459-8012.

What is Theodore Logan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Theodore Logan was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 36 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.