NPIMap

Organization Active NPI

Mortenson Family Dental Center - Dixie at Rockford Lane, PLLC

  • Dentist
  • Louisville, KY
National Provider Identifier
1013309905
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MORTENSON FAMILY DENTAL CENTER - DIXIE AT ROCKFORD LANE, PLLC
Practice address
4740 Dixie Hwy
Louisville, KY 40216-2656
Phone
(502) 447-8992
NPI assigned
Mar 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephen James
Title
Cfo
Phone
(502) 254-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4740 Dixie Hwy
Louisville, KY 40216-2656

Mailing address

4740 Dixie Hwy
Louisville, KY 40216-2656
Phone (502) 447-8992

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1013309905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402162656",
            "telephone_number": "502-447-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402162656",
            "telephone_number": "502-447-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL CENTER - DIXIE AT ROCKFORD LANE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8500"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.