MORTENSON FAMILY DENTAL CENTER-HIGHLANDS PLLC (NPI# 1497905244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497905244 |
| Entity Type | Organization |
| Organization Name | MORTENSON FAMILY DENTAL CENTER-HIGHLANDS PLLC |
| Practice Address |
2105 Weber Ave Louisville KY 40205-2110 |
| Mailing Address |
Po Box 437169 Louisville KY 40253-7169 |
| Practice Telephone | 5024732011 |
| Practice Fax Number | 5024732013 |
| Mailing Telephone | 5022548501 |
| Mailing Fax Number | 5028051957 |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2014-09-17 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100278400 | 05 |
| Street Address |
2105 WEBER AVE |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40205-2110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861629941 | Tyson Perrero | Dentist | 2105 Weber Ave, Louisville, KY 40205-2110 | 2009-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558844027 | Arthur James Shulthise Jr. | Family Medicine | Bldg. 2801 - Bowman Field, 2801 Taylorsville Road, Louisville, KY 40205 | 2018-09-11 |
| 1609392133 | Leah Elizabeth Storch | Occupational Therapist | 2231 Wendell Ave, Louisville, KY 40205 | 2017-08-16 |
| 1437679842 | Michael Edward Lovelace | Family Medicine | 1800 Stevens Avenue, Louisville, KY 40205 | 2017-06-27 |
| 1699205328 | Nathaniel George Kennedy | Physician Assistant | 3101 Bardstown Road, Sullivan University Physician Assistant Program, Louisville, KY 40205 | 2017-06-14 |
| 1225584972 | Kalpana Bhaskar | Pharmacist | 3036 Bardstown Road, Louisville, KY 40205 | 2016-08-31 |
| 1013398627 | William Wood | Hearing Instrument Specialist | 2239 Bardstown Rd., Louisville, KY 40205 | 2015-06-10 |
| 1811306707 | Alaina Rotelli | Pharmacist | 2100 Gardiner Lane, Louisville, KY 40205 | 2014-08-05 |
| 1013325760 | Jaime Alexandra Seelmeyer | Counselor | 1718 Deerwood Ave, Apt 1, Louisville, KY 40205 | 2014-07-25 |
| 1992009336 | Priscilla Freeman | Case Manager/Care Coordinator | 3171 Taylorsville Rd, 1st Floor, Louisville, KY 40205 | 2010-12-28 |
| 1457501413 | Amanda Christine Voils-levenda | Psychologist | 1911 Bardstown Rd, Suite #bl, Louisville, KY 40205 | 2008-09-26 |
| Find all providers in zip 40205 | ||||
| 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 | 40205 |
Please comment or provide details below to improve the information on MORTENSON FAMILY DENTAL CENTER-HIGHLANDS 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.