MORTENSON FAMILY DENTAL CENTER (NPI# 1407167463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407167463 |
| Entity Type | Organization |
| Organization Name | MORTENSON FAMILY DENTAL CENTER |
| Other Organization Name | ENGILMAN ORTHODONTICS |
| Practice Address |
10640 Dixie Hwy Louisville KY 40272-4350 |
| Mailing Address |
Po Box 437169 Louisville KY 40253-7169 |
| Practice Telephone | 5029334455 |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2010-06-24 |
| Authorized Official Name | STEVE JAMES (CFO) |
| Authorized Official Telephone | 5022548504 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| engilman orthodontics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699922849 | Mortenson Family Dental Center | Clinic/Center | 6408 W Hwy 146, Crestwood, KY 40014 | 2008-08-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | MORTENSON FAMILY DENTAL CENTER - CLARKSVILLE, LLC | 134 N Evergreed Rd Ste 200, Middletown, KY 40243 |
| Indiana Business Entities | MORTENSON FAMILY DENTAL CENTER - CORYDON LLC | 11801 Brinley Ave., Suite 100, Middletown, KY 40243 |
| Indiana Business Entities | MORTENSON FAMILY DENTAL CENTER - LAWRENCEBURG, LLC | 11801 Brinley Ave Ste 100, Middletown, KY 40243 |
| Indiana Business Entities | MORTENSON FAMILY DENTAL CENTER - NEW ALBANY, LLC | 11801 Brinley Ave, Suite 100, Middletown, KY 40243 |
| Street Address |
10640 DIXIE HWY |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40272-4350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043294945 | Heather Lindsay Walker | Dentist | 10640 Dixie Hwy, Louisville, KY 40272-4350 | 2005-12-04 |
| 1114309986 | Susan Wofford Himschoot | Dentist | 10640 Dixie Hwy, Louisville, KY 40272-4350 | 2015-06-29 |
| 1427376490 | Mortenson Family Dental Center-valley Station | Clinic/Center | 10640 Dixie Hwy, Louisville, KY 40272-4350 | 2010-05-14 |
| 1902878531 | Jason M Howell | Dentist | 10640 Dixie Hwy, Louisville, KY 40272-4350 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649795105 | Jewell Elizabeth Berger | Occupational Therapist | 9700 Stone Street Rd, Louisville, KY 40272 | 2017-08-07 |
| 1235668658 | Jessica Cook | Occupational Therapy Assistant | 12420 Hedgeapple Way, Louisville, KY 40272 | 2017-06-08 |
| 1033468525 | Shawn Thomas Benningfield | Counselor | 9702 Stonestreet Rd Ste 120, Louisville, KY 40272 | 2012-08-30 |
| 1386956415 | Jeannette M Martin | Marriage & Family Therapist | 9800 Stonestreet Rd, Louisville, KY 40272 | 2010-07-06 |
| 1437346145 | Community Family Living, LLC | Day Training, Developmentally Disabled Services | 610 Valley College Dr., Louisville, KY 40272 | 2007-09-26 |
| 1982797403 | William Spencer Shipley | Dentist | 9900 Old Third Street Road, Louisville, KY 40272 | 2006-10-02 |
| 1962513317 | Teresa May Wright | Nurse Practitioner | 1912 Penile Rd, Valley Station, KY 40272 | 2006-08-31 |
| 1710400734 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 701 Valley College Dr, Louisville, KY 40272 | 2017-07-21 |
| 1952851859 | Renew Recovery, LLC | Substance Abuse Rehabilitation Facility | 9702 Stonestreet Rd, Suite 120, Louisville, KY 40272 | 2016-10-04 |
| 1780090233 | Umama Sadia | Family Medicine | 9702 Stonestreet Rd, Louisville, KY 40272 | 2014-07-05 |
| Find all providers in zip 40272 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114530748 | Sol Dental Pllc | Clinic/Center | 1371 Hecla Dr Ste D2, Louisville, CO 80027-2318 | 2020-08-24 |
| 1144838970 | Superior Smiles, LLC | Clinic/Center | 16690 E Main St, Louisville, MS 39339-2750 | 2020-07-17 |
| 1629696505 | Kauffmann and Sims Dentistry Pllc | Clinic/Center | 3935 Dupont Cir Ste A, Louisville, KY 40207-4824 | 2020-07-08 |
| 1699394783 | Professional Dental Services of Kentucky Psc | Clinic/Center | 4814 Outer Loop Ste A, Louisville, KY 40219-3302 | 2020-04-09 |
| 1316579279 | Shannon P Johnson Dmd Pllc | Clinic/Center | 9510 Ormsby Station Rd Ste 203, Louisville, KY 40223-4083 | 2020-02-09 |
| 1306306253 | Tds Ky Two | Clinic/Center | 5141 Dixie Hwy Ste 101, Louisville, KY 40216-1765 | 2019-03-25 |
| 1669937058 | Hometown Family Dental | Clinic/Center | 4122 Shelbyville Rd Ste C, Louisville, KY 40207-3212 | 2019-02-10 |
| 1447714944 | Cobalt Dental Care, LLC | Clinic/Center | 225 S Hurstbourne Pkwy Ste 102, Louisville, KY 40222-4929 | 2019-01-29 |
| 1285129882 | Combs Family Dentistry | Clinic/Center | 2300 Terra Crossing Blvd Ste 108, Louisville, KY 40245-5906 | 2018-06-26 |
| 1972097277 | D & D Dental Enterprises | Clinic/Center | 6790 Dixie Hwy, Louisville, KY 40258 | 2018-06-20 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40272 |
Please comment or provide details below to improve the information on MORTENSON FAMILY DENTAL CENTER.
| 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.