NPIMap

Organization Active NPI

Gregory B Mortensen DDS

  • Point of Service
  • Bellevue, WA
National Provider Identifier
1316491244
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
4778 Issued in WA
Legal business name
GREGORY B MORTENSEN DDS
Practice address
14645 Bel Red Rd Ste 100
Bellevue, WA 98007-3929
Phone
(425) 644-2205
NPI assigned
Aug 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Authorized official

Name
Dr. Gregory Mortensen, DDS
Title
Dentist
Phone
(425) 644-2205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 4778 WA Primary

Addresses

Primary practice location

14645 Bel Red Rd Ste 100
Bellevue, WA 98007-3929

Mailing address

14645 Bel Red Rd Ste 100
Bellevue, WA 98007-3929
Phone (425) 644-2205

National Provider Directory

National Provider Directory

Locations

14645 NE Bel Red Rd
Ste 100
Bellevue, WA 98007
Phone (425) 644-2205

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": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1316491244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14645 BEL RED RD STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073929",
            "telephone_number": "425-644-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14645 BEL RED RD STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073929",
            "telephone_number": "425-644-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY B MORTENSEN DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "MORTENSEN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "425-644-2205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WA",
            "license": "4778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.