MORTENSON FAMILY DENTAL CENTER - INDEPENDENCE, LLC (NPI# 1760920805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760920805 |
| Entity Type | Organization |
| Organization Name | MORTENSON FAMILY DENTAL CENTER - INDEPENDENCE, LLC |
| Practice Address |
2052 Harris Pike Independence KY 41051-7783 |
| Practice Telephone | 8598982255 |
| Practice Fax Number | 8598982730 |
| Mailing Telephone | (859) 898-2255 |
| Mailing Fax Number | 8598982730 |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2017-05-24 |
| Authorized Official Name | STEPHEN JAMES (CFO) |
| 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 |
2052 HARRIS PIKE |
| City | INDEPENDENCE |
| State | KY |
| Zip Code | 41051-7783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738741 | Tina Hacker | Counselor | Crossroads Treatment Centers, 1974 Walton Nicholson Rd, Independence, KY 41051 | 2020-10-26 |
| 1942844972 | Shelby Cuellar | Chiropractor | 2051 Centennial Boulevard, Independence, KY 41051 | 2019-11-02 |
| 1811246242 | Independence Chiropractic, Inc. | Chiropractor | 1922 Walton Nichoolson Road, Independence, KY 41051 | 2012-08-30 |
| 1356627269 | Nina Carmen Brock | Home Health | 593 Berlander Dr, Independence, KY 41051 | 2011-10-25 |
| 1508000951 | Independence Urgent Care LLC | Clinic/Center | 2025 Declaration Drive, Independence, KY 41051 | 2009-04-29 |
| 1710009436 | Ashley Joseph Moser | Dentist | 2047 Centennial Blvd, Independence, KY 41051 | 2007-04-04 |
| 1558497388 | Occupational Health Centers of The Southwest, P.a., P.s.c. | Clinic/Center | 10110 Toebben Drive, Enterprise V Park, Independence, KY 41051 | 2007-02-26 |
| 1982758736 | Janice Ann Struckhoff | Dentist | 1986 Walton Nicholson Pike, Independence, KY 41051 | 2007-01-22 |
| 1265509061 | Regency Manor LLC | Assisted Living Facility | 11725 Madison Pike, Independence, KY 41051 | 2006-11-29 |
| 1588629463 | John Franklin Allnutt | Family Medicine | 5290 Madison Pike, Ste 100, Independence, KY 41051 | 2006-04-20 |
| Find all providers in zip 41051 | ||||
| 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 |
|---|---|---|---|---|
| 1568946523 | Thomas M Bilski Dds and Associates Inc | Dentist | 6527 Brecksville Rd Ste B, Independence, OH 44131-4859 | 2018-09-17 |
| 1790276442 | Julia Suzanne Jenkins | Dentist | 2052 Harris Pike # 54, Independence, KY 41051-7783 | 2018-05-29 |
| 1659768596 | Terry Charles Williams | Dentist | 17008 E 45th St S, Independence, MO 64055-7630 | 2015-04-17 |
| 1154737658 | Devishkumar H Patel | Dentist | 2320 W Main St, Independence, KS 67301-8435 | 2014-07-03 |
| 1609182286 | Jeffrey David Peter | Dentist | 2025 Declaration Dr Ste B, Independence, KY 41051-7983 | 2010-08-20 |
| 1831427731 | Michael James Beauregard | Dentist | 11105 E Winner Rd, Independence, MO 64052-3837 | 2009-12-03 |
| 1679733265 | Porter James Clark | Dentist | 422 E Main St, Independence, KS 67301-3716 | 2008-06-17 |
| 1447458773 | Danny Nakhla | Dentist | 5302 Madison Pike, Independence, KY 41051-8652 | 2007-07-09 |
| 1609071067 | Carl James Stefaniak | Dentist | 6533 Brecksville Road, Suite A, Independence, OH 44131-4897 | 2007-06-17 |
| 1457554933 | Leann Thuy Nguyen | Dentist | 3905 S Lynn Ct, Independence, MO 64055-3337 | 2007-06-11 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 41051 |
Please comment or provide details below to improve the information on MORTENSON FAMILY DENTAL CENTER - INDEPENDENCE, LLC.
| 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.