Provider Demographics
NPI:1780945725
Name:LOGSDON, JAMES BRIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRIAN
Last Name:LOGSDON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 WINDSORMERE WAY
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6592
Mailing Address - Country:US
Mailing Address - Phone:407-890-9116
Mailing Address - Fax:
Practice Address - Street 1:35 WINDSORMERE WAY
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6592
Practice Address - Country:US
Practice Address - Phone:407-890-9116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 198921223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics