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NPI Code Detail

MEDICARE: DR. LOGAN LAMBERTON DDS

MEDICARE: DR. LOGAN LAMBERTON DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry12014991AIN

General Provider Information

NPI Number : 1306778139
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOGAN LAMBERTON DDS
Provider Business Mailing Address
First Line : 4710 CROMWELL DR
Second Line :
City : EVANSVILLE
State : IN
Zip : 47725-7420
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1481 W 10TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2803
Country : US
Telephone Number : 317-988-2733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ DR. LOGAN LAMBERTON DDS” Practice Location

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