Sophie Logan DDS MMSC PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SOPHIE LOGAN DDS MMSC PC

Doing business as

Sea Glass Orthodontics

Practice address

824 Mission St
Santa Cruz, CA 95060-3681

Phone

(707) 849-3113

NPI assigned

Jul 18, 2024

Last updated

Feb 7, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sophie Logan, DDS, MMSCNPI 1568008407

Title

Orthodontist

Phone

(831) 531-7660

Specialties & licenses 1

Addresses

Other names 1

• Sea Glass Orthodontics Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sophie Elizabeth Logan, DDS, MMSC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Santa Cruz, CA
  • NPI 1568008407
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738886400000",
    "number": "1255179636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 SEGRE PL",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603160",
            "telephone_number": "831-331-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 MISSION ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603681",
            "telephone_number": "707-849-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOPHIE LOGAN DDS MMSC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-18",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "SOPHIE",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "831-531-7660",
        "authorized_official_credential": "DDS, MMSC"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sea Glass Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sea Glass Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Theresa Marie Soltzberg, MFT
• Sivanna Ruth Sommerville
• Christian Somoon
• Sonus-USA, Inc.
• Lisa Soon, LMFT
• Soquel Care LLC (Redwood Grove Post Acute)
• Jessica Sorci, LMFT
• Grace Anita Sorenson, RN BSN
• Gabriel Soriano
• Tanya Riva Sorin

• Dental Clinic/Center in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.