MORTENSON FAMILY DENTAL CENTER-FOREST GREEN, PLLC (NPI# 1972779445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972779445 |
| Entity Type | Organization |
| Organization Name | MORTENSON FAMILY DENTAL CENTER-FOREST GREEN, PLLC |
| Practice Address |
10031 Forest Green Blvd Louisville KY 40223-5119 |
| Mailing Address |
Po Box 437169 Louisville KY 40253-7169 |
| Practice Telephone | 5024127587 |
| Practice Fax Number | 5024127066 |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2008-05-05 |
| Authorized Official Name | STEVE JAMES (COO) |
| 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 |
| Street Address |
10031 FOREST GREEN BLVD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40223-5119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790848026 | Lifetime Dental Care of Kentucky, P.s.c. - Dr Wayne Olges | Dentist | 10031 Forest Green Blvd, Louisville, KY 40223-5119 | 2006-12-18 |
| 1366656399 | Kim Owen | Dentist | 10031 Forest Green Blvd, Louisville, KY 40223-5119 | 2007-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235605668 | Ashlee Brooke Colville | Counselor | 13121 Esat Point Park Blvd, Suite F, Louisville, KY 40223 | 2018-10-24 |
| 1831619758 | Tracie S Lain | Developmental Therapist | 13101 Eastpoint Park Blvd., Louisville, KY 40223 | 2017-06-21 |
| 1972051399 | Ruby Denise Brooks | Counselor | 1407 Lafontenay Ct, Louisville, KY 40223 | 2016-09-14 |
| 1427409085 | Victoria Krepps Terrell | Nurse Practitioner | 13301 Shelbyville Rd Ste 103, Louisville, KY 40223 | 2016-06-24 |
| 1033570098 | Mackenzie Sipes | Chiropractor | 401 Creason Ct Unit 205, Louisville, KY 40223 | 2016-03-17 |
| 1699151258 | Chelsey Layne Gorham | Marriage & Family Therapist | 13121 Eastpoint Park Blvd Ste F, Louisville, KY 40223 | 2015-08-06 |
| 1356764187 | Paula Renee Garner | Social Worker | 1015 Dorsey Lane, Louisville, KY 40223 | 2014-01-30 |
| 1588086508 | Lori Bettenhausen Williams | Ophthalmology | 1413 Evergreen Rd, Anchorage, KY 40223 | 2014-01-09 |
| 1417392259 | Lauren Parsons Berry | Dentist | 9780 Ormsby Station Rd, Suite 1200, Louisviile, KY 40223 | 2013-05-07 |
| 1336486653 | Lynn M Pendley | Dietitian, Registered | 9400 Mill Brook Rd, Northeast Ymca, Louisville, KY 40223 | 2013-01-07 |
| Find all providers in zip 40223 | ||||
| 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 | 40223 |
Please comment or provide details below to improve the information on MORTENSON FAMILY DENTAL CENTER-FOREST GREEN, 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.