MORTENSON FAMILY DENTAL (NPI# 1881706547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881706547 |
| Entity Type | Organization |
| Organization Name | MORTENSON FAMILY DENTAL |
| Practice Address |
911 Palatka Rd Louisville KY 40214-3461 |
| Mailing Address |
134 N Evergreen Rd Suite 102 Middletown KY 40243-1487 |
| Practice Telephone | 5023662448 |
| Practice Fax Number | 5023663551 |
| 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 |
| Authorized Official Credential | DMD |
| 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 |
| 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 |
911 PALATKA RD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40214-3461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760599120 | Garry Meeks Jr. | Dentist | 911 Palatka Rd, Louisville, KY 40214-3461 | 2006-08-23 |
| 1336520832 | Brandon Tyler James | Dentist | 911 Palatka Rd, Louisville, KY 40214-3461 | 2015-06-11 |
| 1033359047 | Endodontics-iroquois Park, Pllc | Clinic/Center | 911 Palatka Rd, Louisville, KY 40214-3461 | 2009-03-03 |
| 1427210384 | Thomas Vivian | Dentist | 911 Palatka Rd, Louisville, KY 40214-3461 | 2008-07-01 |
| 1962680843 | Specialized Dental Services-iroquois Park, Pllc | Clinic/Center | 911 Palatka Rd, Louisville, KY 40214-3461 | 2008-02-04 |
| 1457468530 | Cassie Wence | Dentist | 911 Palatka Rd, Louisville, KY 40214-3461 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477058659 | Abcdentistry | Clinic/Center | 5316 S 3rd St, Louisville, KY 40214 | 2018-03-28 |
| 1538591300 | Byrne Dental,psc | Dentist | 4739 So. Third Street, Louisville, KY 40214 | 2013-08-05 |
| 1205110400 | Michael Wayne Probst | Pharmacist | 5201 South Third Street, Louisville, KY 40214 | 2011-10-06 |
| 1871876920 | Cindy Eillene Ohlmann | Pharmacist | 5400 New Cut Road, Louisville, KY 40214 | 2011-09-26 |
| 1801129960 | Deborah Suzanne Slusher | Speech-Language Pathologist | 109 Seneca Trail, Louisville, KY 40214 | 2009-09-08 |
| 1255592267 | Mitisha Nichole Martin | Dentist | 5316 S. 3rd Street, Louisville, KY 40214 | 2008-06-23 |
| 1588862361 | Kentucky Eye Surgery Associates Psc | Ophthalmology | 4940 Hazelwood Avenue, Louisville, KY 40214 | 2007-07-03 |
| 1558565739 | James Latroy Burks | Counselor | 927 Southview Rd, Louisville, KY 40214 | 2007-06-12 |
| 1770792475 | Kimberly Lynn Wheatley | Physical Therapist | 250 Kenwood Hill Road, Louisville, KY 40214 | 2007-05-21 |
| 1821219601 | Courtney Marie Smith | Speech-Language Pathologist | 3222 Rolling Oak Blvd, Louisville, KS 40214 | 2007-05-01 |
| Find all providers in zip 40214 | ||||
| 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 | 40214 |
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.