Sophie Elizabeth Logan, DDS, MMSC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

106072 Issued in CA

Practice address

824 Mission St
Santa Cruz, CA 95060-3681

Phone

(831) 331-1903

NPI assigned

Nov 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sophie Logan DDS MMSC PC

  • Dental Clinic/Center
  • Santa Cruz, CA
  • NPI 1255179636
  NPD Authorized official

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1568008407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 TORREY PINE TER",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603243",
            "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": "831-331-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "SOPHIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DDS, MMSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-26",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "106072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makayla Renee Lockard
• Glen Locke, PTA
• Lindsey Locke
• Julie A Lockwood
• Shaelyn Loesche
• Ielyzaveta Logvynenko
• Cybele Lolley, MFT
• Xochitl Margarita Lomeli Corona, ASSOCIATE CLINICAL S
• Giovanni Lomeli-Mejia
• Oliver Lomeli

• Orthodontics and Dentofacial Orthopedics Dentistry in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry 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.