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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

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

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: July 19, 2026.

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


The following 20 providers are registered at the same or a nearby location.

RICHARD A PAPE DMD MS
Dentist (Oral and Maxillofacial Surgery)
3101 BRECKENRIDGE LN, STE 2D
LOUISVILLE, KY 40220
Jefferson County (502) 459-8012
WILLIAM M EPSTEIN DMD
Dentist (Oral and Maxillofacial Surgery)
3101 BRECKENRIDGE LN, STE 2D
LOUISVILLE, KY 40220
Jefferson County (502) 459-8012
JULIE M HARRIS DMD
Dentist (Oral and Maxillofacial Surgery)
3101 BRECKENRIDGE LN, STE 2D
LOUISVILLE, KY 40220
Jefferson County (502) 459-8012
TODD G KUKUCK 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
MARK R BEHR MD
Anesthesiology
3101 BRECKENRIDGE LN, SUITE 1A
LOUISVILLE, KY 40220
Jefferson County (502) 458-7400
SANDRA D BAILEY CRNA
Nurse Anesthetist, Certified Registered
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
CHRISTOPHER C EHRLER CRNA
Nurse Anesthetist, Certified Registered
3101 BRECKENRIDGE LN, SUITE 1A
LOUISVILLE, KY 40220
Jefferson County (502) 458-7400
KATHRYN A PIOTROWSKI CRNA
Nurse Anesthetist, Certified Registered
3101 BRECKENRIDGE LN, SUITE 1A
LOUISVILLE, KY 40220
Jefferson County (502) 458-7400
KENNETH M RICHTER MD
Anesthesiology
3101 BRECKENRIDGE LN, SUITE 1A
LOUISVILLE, KY 40220
Jefferson County (502) 458-7400
ANESTHESIOLOGY ASSOCIATES PSC
Anesthesiology
3101 BRECKENRIDGE LN, SUITE 1A
LOUISVILLE, KY 40220
Jefferson County (502) 458-7400
DIANA MARIE BANKS ARNP, CDE
Nurse Practitioner (Family)
3101 BRECKENRIDGE LN, 4E
LOUISVILLE, KY 40220
Jefferson County (502) 454-5252
MYRON F SHUSTER DMD
Dentist (Pediatric Dentistry)
3101 BRECKENRIDGE LN, SUITE 4B
LOUISVILLE, KY 40220
Jefferson County (502) 451-1020
DR. JENNIFER LYNN WRIGHT DDS
Dentist (General Practice)
3101 BRECKENRIDGE LN, SUITE 2A
LOUISVILLE, KY 40220
Jefferson County (502) 451-5222
HERSHEL WEINBERG DDS
Dentist (General Practice)
3101 BRECKENRIDGE LN, SUITE 2A
LOUISVILLE, KY 40220
Jefferson County (502) 451-5222
DR. MARK A BLAIR D.M.D.
Dentist (General Practice)
3101 BRECKENRIDGE LN, 1-D
LOUISVILLE, KY 40220
Jefferson County (502) 458-0172
ANTHONY KELTY
Nurse Anesthetist, Certified Registered
3101 BRECKENRIDGE LN, SUITE 1A
LOUISVILLE, KY 40220
Jefferson County (502) 458-7400
MYRON F SHUSTER, DMD
Dentist (Pediatric Dentistry)
3101 BRECKENRIDGE LN, SUITE 4B
LOUISVILLE, KY 40220
Jefferson County (502) 451-1020
GREATER LOUISVILLE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, PSC
Dentist (Oral and Maxillofacial Surgery)
3101 BRECKENRIDGE LN, STE 2D
LOUISVILLE, KY 40220
Jefferson County (502) 459-8012

Frequently Asked Questions

What is Theodore Logan's NPI number?

The NPI number assigned to this healthcare provider is 1245231778, enumerated as an "individual" on August 09, 2005.

Where is the provider located?

The provider is located at 3101 BRECKENRIDGE LN STE 2D LOUISVILLE, KY 40220 and the phone number is (502) 459-8012.

What is the provider's specialty?

Dentist with taxonomy code 1223S0112X and a focus in Oral and Maxillofacial Surgery.

What insurance does Theodore Logan accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.