MORTENSON FAMILY DENTAL (NPI# 1407968159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407968159 |
| Entity Type | Organization |
| Organization Name | MORTENSON FAMILY DENTAL |
| Practice Address |
8711 Old Bardstown Rd Louisville KY 40291-4435 |
| Mailing Address |
134 N Evergreen Rd Suite 102 Middletown KY 40243-1487 |
| Practice Telephone | 5022314633 |
| Practice Fax Number | 5022314722 |
| Mailing Telephone | 5022457103 |
| Mailing Fax Number | 5022532202 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. OWEN WAYNE MORTENSON (GEN. DENTIST/OWNER) |
| Authorized Official Telephone | 5022458627 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487757761 | Mortenson Family Dental | Clinic/Center | 110 N. Locust St, Carlisle, KY 40311 | 2006-09-05 |
| 1306949466 | Mortenson Family Dental | Clinic/Center | 1746 Highway 44 E, Shepherdsville, KY 40165-6131 | 2006-09-06 |
| 1790897882 | Mortenson Family Dental | Clinic/Center | 1430 Poplar Level Rd, Louisville, KY 40217-1345 | 2006-08-31 |
| 1881706547 | Mortenson Family Dental | Clinic/Center | 911 Palatka Rd, Louisville, KY 40214-3461 | 2006-08-31 |
| 1730291493 | Mortenson Family Dental | Clinic/Center | 2005 S Highway 53, Lagrange, KY 40031-9109 | 2006-08-31 |
| 1760593602 | Mortenson Family Dental | Clinic/Center | 11708 Main St, Middletown, KY 40243-1426 | 2006-08-31 |
| 1477665156 | Mortenson Family Dental | Clinic/Center | 2441 State St, New Albany, IN 47150-4962 | 2006-08-31 |
| 1376655498 | Mortenson Family Dental | Clinic/Center | 5222 Dixie Hwy, Louisville, KY 40216-1704 | 2006-08-31 |
| 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 |
8711 OLD BARDSTOWN RD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40291-4435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215044664 | Charles Bryan Fox | Dentist | 8711 Old Bardstown Rd, Louisville, KY 40291-4435 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881117166 | The Degondaba School, Inc. | Day Training, Developmentally Disabled Services | 5110 Stony Brook Drive, Louisville, KY 40291 | 2017-07-19 |
| 1497108278 | Andrea Herndon | Physician Assistant | 10710 Marceitta Ct, Louisville, KY 40291 | 2016-07-18 |
| 1033536602 | Jennifer Rose Fowler | Social Worker | 10300 Brookridge Villeage Blvd., Suite 104, Louisville, KY 40291 | 2014-03-21 |
| 1740602069 | Brittney Tatum | Licensed Practical Nurse | 9500 Glen Trace Ln, Louisville, KY 40291 | 2014-01-07 |
| 1326392895 | Lisa J Fetter | Nurse Practitioner | 6413 Bardstown Rd, Louisville, KY 40291 | 2012-11-05 |
| 1275829137 | Carolyn Estep Book | Counselor | 9612 Farmstead Lane, Louisville, KY 40291 | 2011-06-20 |
| 1023309028 | Julie Klein Hawkins | Pharmacist | 8014 Bardstown Rd., Louisville, KY 40291 | 2011-04-25 |
| 1295872653 | Loving Care Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9508 Fairmount Rd, Louisville, KY 40291 | 2007-02-01 |
| 1962548198 | Morgan Howard | Chiropractor | 5501 Bardstown Rd, Louisville, KY 40291 | 2007-01-29 |
| 1407992258 | Deanna H Smith | Social Worker | 9409 Cedar Look Drive, Louisville, KY 40291 | 2007-01-29 |
| Find all providers in zip 40291 | ||||
| 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 | 40291 |
Please comment or provide details below to improve the information on MORTENSON FAMILY DENTAL.
| 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.