MORTENSON FAMILY DENTAL CENTER - SIMPSONVILLE, PLLC (NPI# 1285978288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285978288 |
| Entity Type | Organization |
| Organization Name | MORTENSON FAMILY DENTAL CENTER - SIMPSONVILLE, PLLC |
| Practice Address |
137 Buck Creek Rd Simpsonville KY 40067-6674 |
| Mailing Address |
Po Box 437169 Louisville KY 40253-7169 |
| Practice Telephone | 5027222110 |
| Practice Fax Number | 5027222116 |
| Mailing Telephone | 5022548500 |
| Mailing Fax Number | 5022455021 |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |
| Authorized Official Name | RONEL MCCOMBS (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 5022548500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
137 BUCK CREEK RD |
| City | SIMPSONVILLE |
| State | KY |
| Zip Code | 40067-6674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396112546 | Bethany Shively | Nurse Practitioner | 2156 Todds Point Road, Simpsonville, KY 40067 | 2015-08-24 |
| 1780943423 | Shelli Dry Pediatric Therapy, Pllc | Specialist | 40 Liza's Cir., Simpsonville, KY 40067 | 2012-05-15 |
| 1588808281 | Diane M Banic | Psychologist | 1219 Taylorwood Rd, Simpsonville, KY 40067 | 2009-04-24 |
| 1235261538 | Shelli Dry | Specialist | 40 Liza's Circle, Simpsonville, KY 40067 | 2007-03-12 |
| 1639579451 | Angels Behavior Services | Community/Behavioral Health | 25 Timberwood Dr, Simpsonville, KY 40067-5404 | 2014-08-28 |
| 1609051655 | Kara Baughman | Social Worker | 532 Reserves Ct, Simpsonville, KY 40067-5465 | 2008-01-08 |
| 1801434071 | Morgan Utterback | Counselor | 3180 Countryside Dr, Simpsonville, KY 40067-5615 | 2019-12-18 |
| 1922266113 | Kerrin Omer | Case Manager/Care Coordinator | 151 Old Stone Dr, Simpsonville, KY 40067-5658 | 2008-05-25 |
| 1417409681 | Servant Hearts LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 626 Crum Ct, Simpsonville, KY 40067-5662 | 2016-11-03 |
| 1821110909 | Amber D Durr | Counselor | 521 Todds Point Rd, Simpsonville, KY 40067-6418 | 2007-04-06 |
| Find all providers in zip 40067 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972073831 | Dental Professional of South Carolina, P.C. | Dentist | 2800 Woodruff Rd, Simpsonville, SC 29681-4806 | 2018-12-04 |
| 1518482835 | Julia Lynne Findlay | Dentist | 340 Harrison Bridge Rd Ste D, Simpsonville, SC 29680-7133 | 2017-08-08 |
| 1962924407 | Logan Donald King | Dentist | 668 Fairview Rd # B, Simpsonville, SC 29680-6708 | 2017-07-15 |
| 1487013108 | Dental Professionals of South Carolina, PC | Dentist | 340 Harrison Bridge Rd, Suite D, Simpsonville, SC 29680-7133 | 2016-02-23 |
| 1457733446 | Elizabeth A Huggins | Dentist | 745 Se Main St # 3237, Simpsonville, SC 29681-3237 | 2015-06-25 |
| 1528455268 | Jake Jacomet | Dentist | 634b Fairview Rd, Simpsonville, SC 29680-6700 | 2015-04-21 |
| 1598177784 | Laura Rebecca Hofto | Dentist | 216 Scuffletown Rd Ste E, Simpsonville, SC 29681-7296 | 2014-05-22 |
| 1811251036 | Leanna Christine Shetler | Dentist | 11 Magnolia Cove Drive, Simpsonville, SC 29680-2968 | 2012-07-02 |
| 1871806612 | Lauriant Azangue | Dentist | 209 Teaticket Ct, Simpsonville, SC 29681-5790 | 2010-07-21 |
| 1710290663 | Ryan O'malley | Dentist | 419 Se Main St Ste 100, Simpsonville, SC 29681-2674 | 2010-07-21 |
| Find all providers in SIMPSONVILLE | ||||
| City | SIMPSONVILLE |
| Zip Code | 40067 |
Please comment or provide details below to improve the information on MORTENSON FAMILY DENTAL CENTER - SIMPSONVILLE, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.