Provider Demographics
NPI:1972618395
Name:LOGEMAN, JAMES WADE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WADE
Last Name:LOGEMAN
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 1:318 READING RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1568
Mailing Address - Country:US
Mailing Address - Phone:513-398-0133
Mailing Address - Fax:513-398-3014
Practice Address - Street 1:318 READING RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1568
Practice Address - Country:US
Practice Address - Phone:513-398-0133
Practice Address - Fax:513-398-3014
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0182471223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics