TIMOTHY W. LOGAN, D.M.D., P.S.C. (NPI# 1427349687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427349687 |
| Entity Type | Organization |
| Organization Name | TIMOTHY W. LOGAN, D.M.D., P.S.C. |
| Practice Address |
9800 Shelbyville Rd Suite 202 Louisville KY 40223-5440 |
| Mailing Address |
9800 Shelbyville Road Suite 202 Louisville KY 40223-5440 |
| Practice Telephone | 5024290526 |
| Practice Fax Number | 5024290532 |
| Mailing Telephone | 5024290526 |
| Mailing Fax Number | 5024290532 |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2011-04-22 |
| Authorized Official Name | DR. TIMOTHY WILSON LOGAN (OWNER) |
| Authorized Official Telephone | 5024290526 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5015 | KY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS/BLUE SHIEL | 000000049874 | 01 | |
| NPI TYPE 1 | 1548227655 | 01 |
| Street Address |
9800 SHELBYVILLE RD SUITE 202 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40223-5440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629077698 | Stephen J. Pollard | Allergy & Immunology | 9800 Shelbyville Rd, Suite #220, Louisville, KY 40223-2992 | 2005-07-20 |
| 1447721584 | Katie A Davis | Nurse Practitioner | 9800 Shelbyville Rd, Ste 220, Louisville, KY 40223-2992 | 2018-12-16 |
| 1023482106 | Tiffany Susan Helmerich | Nurse Practitioner | 9800 Shelbyville Rd, Ste 220, Louisville, KY 40223-2992 | 2015-11-30 |
| 1760807556 | Vanessa J Magee | Nurse Practitioner | 9800 Shelbyville Rd, Ste 220, Louisville, KY 40223-2992 | 2014-03-03 |
| 1467889725 | Susan K Hampton | Nurse Practitioner | 9800 Shelbyville Rd, Ste 220, Louisville, KY 40223-2992 | 2013-10-02 |
| 1447539440 | Stacy Yvonne Wright | Nurse Practitioner | 9800 Shelbyville Rd, Ste 220, Louisville, KY 40223-2992 | 2011-08-08 |
| 1033436282 | University Pediatrics Foundation, Inc. | Allergy & Immunology | 9800 Shelbyville Rd, Louisville, KY 40223-2977 | 2010-04-28 |
| 1730419599 | Stephanie P Wallace | Nurse Practitioner | 9800 Shelbyville Rd, Suite #220, Louisville, KY 40223-2992 | 2009-12-30 |
| 1235395781 | Natalie Beaven Miller | Allergy & Immunology | 9800 Shelbyville Rd, Suite #220, Louisville, KY 40223-2992 | 2008-08-04 |
| 1275705014 | Brandi Hunley Dyer | Allergy & Immunology | 9800 Shelbyville Rd, Suite #220, Louisville, KY 40223-2992 | 2008-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235605668 | Ashlee Brooke Colville | Counselor | 13121 Esat Point Park Blvd, Suite F, Louisville, KY 40223 | 2018-10-24 |
| 1831619758 | Tracie S Lain | Developmental Therapist | 13101 Eastpoint Park Blvd., Louisville, KY 40223 | 2017-06-21 |
| 1972051399 | Ruby Denise Brooks | Counselor | 1407 Lafontenay Ct, Louisville, KY 40223 | 2016-09-14 |
| 1427409085 | Victoria Krepps Terrell | Nurse Practitioner | 13301 Shelbyville Rd Ste 103, Louisville, KY 40223 | 2016-06-24 |
| 1033570098 | Mackenzie Sipes | Chiropractor | 401 Creason Ct Unit 205, Louisville, KY 40223 | 2016-03-17 |
| 1699151258 | Chelsey Layne Gorham | Marriage & Family Therapist | 13121 Eastpoint Park Blvd Ste F, Louisville, KY 40223 | 2015-08-06 |
| 1356764187 | Paula Renee Garner | Social Worker | 1015 Dorsey Lane, Louisville, KY 40223 | 2014-01-30 |
| 1588086508 | Lori Bettenhausen Williams | Ophthalmology | 1413 Evergreen Rd, Anchorage, KY 40223 | 2014-01-09 |
| 1417392259 | Lauren Parsons Berry | Dentist | 9780 Ormsby Station Rd, Suite 1200, Louisviile, KY 40223 | 2013-05-07 |
| 1336486653 | Lynn M Pendley | Dietitian, Registered | 9400 Mill Brook Rd, Northeast Ymca, Louisville, KY 40223 | 2013-01-07 |
| Find all providers in zip 40223 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023510518 | Ralph M. Green Medical Pllc | Dentist | 3809 Poplar Level Rd Ste B, Louisville, KY 40213-1429 | 2018-03-01 |
| 1922361062 | Alan Reisman, Dds, PC | Dentist | 1075 S Boulder Rd Ste 135, Louisville, CO 80027-2559 | 2012-06-22 |
| 1245481175 | Joseph H. Cieslak Dds, Pllc | Dentist | 6501 Dixie Hwy, Louisville, KY 40258-3907 | 2008-10-09 |
| 1033372057 | Lawrence Sivori II | Dentist | 3101 Breckenridge Ln Ste 2d, Louisville, KY 40220-2742 | 2008-07-09 |
| 1790944106 | David Naselsker | Dentist | 3421 Hycliffe Ave, Louisville, KY 40207-3659 | 2008-06-02 |
| 1235329400 | Thad R. Schulten Psc | Dentist | 4515 Churchman Ave., Louisville, KY 40215 | 2007-07-25 |
| 1730382722 | Lewis C. Jones | Dentist | 401 E Chestnut St Unit 550, Louisville, KY 40202-5705 | 2007-06-07 |
| 1104982016 | Mark D. Miller | Dentist | 1211 W Broadway Unit 106, Louisville, KY 40203-2082 | 2006-12-28 |
| 1285709865 | David T Dodd | Dentist | 4122 Shelbyville Rd Ste 120, Louisville, KY 40207-3206 | 2006-11-21 |
| 1306933387 | Alan Jon Reisman | Dentist | 1075 E South Boulder Rd, Suite 230, Louisville, CO 80027-2560 | 2006-10-09 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40223 |
Please comment or provide details below to improve the information on TIMOTHY W. LOGAN, D.M.D., P.S.C..
| 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.