MORTENSON FAMILY DENTAL (NPI# 1790897882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790897882 |
| Entity Type | Organization |
| Organization Name | MORTENSON FAMILY DENTAL |
| Practice Address |
1430 Poplar Level Rd Louisville KY 40217-1345 |
| Mailing Address |
134 N Evergreen Rd Middletown KY 40243-1487 |
| Practice Telephone | 5026360311 |
| Practice Fax Number | 5026368424 |
| 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 | 5026360311 |
| 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 |
| 1881706547 | Mortenson Family Dental | Clinic/Center | 911 Palatka Rd, Louisville, KY 40214-3461 | 2006-08-31 |
| 1407968159 | Mortenson Family Dental | Clinic/Center | 8711 Old Bardstown Rd, Louisville, KY 40291-4435 | 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 |
1430 POPLAR LEVEL RD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40217-1345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548377674 | Robert Fuchs | Dentist | 1430 Poplar Level Rd, Louisville, KY 40217-1345 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720564016 | Kaela Marie Turley | Nurse Practitioner | 2355 Poplar Level Rd Ste 405, Louisville, KY 40217 | 2018-07-19 |
| 1740710623 | Landmark of Louisville Rehabilitation and Nursing Center | Skilled Nursing Facility | 1155 Eastern Parkway, Louisville, KY 40217 | 2017-06-14 |
| 1386185437 | Meredith Brooke Ervin | Counselor | 1169 Eastern Pkwy Ste 3310, Louisville, KY 40217 | 2017-03-08 |
| 1437507621 | Kendra Pickerill | Speech-Language Pathologist | 906 Delor Avenue, Louisville, KY 40217 | 2016-05-27 |
| 1275947186 | Gary Muncy | Massage Therapist | 607 East Brandeis Ave, Louisville, KY 40217 | 2014-06-18 |
| 1912318791 | Stacey Charlotte Elmes | Case Manager/Care Coordinator | 2338 Alexanderave, Louisville, KY 40217 | 2014-05-14 |
| 1275819831 | April Mecasha Cox | Pharmacist | 808 Eastern Parkway, Louisville, KY 40217 | 2011-10-27 |
| 1831346204 | Nikki Renee Wilson | Registered Nurse | 1169 Eastern Pkwy Ste 1226, Louisville, KY 40217 | 2008-08-27 |
| 1497925440 | Sarah Beth Murrow | Chiropractor | 1100 Milton St, Louisville, KY 40217 | 2008-03-06 |
| 1457560302 | Ferenc Pantaleone Nagy | Surgery | 3 Audubon Plaza Dr Ste 220, Louisville, KY 40217 | 2007-05-21 |
| Find all providers in zip 40217 | ||||
| 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 | 40217 |
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.