NPIMap

Organization Active NPI

Mortenson Family Dental Center- Clarksville

  • General Practice Dentistry
  • Clarksville, IN
National Provider Identifier
1407281868
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MORTENSON FAMILY DENTAL CENTER- CLARKSVILLE
Practice address
1240 Veterans Pkwy
Suite 100
Clarksville, IN 47129-2394
Phone
(812) 284-2701
Fax
(812) 282-2721
NPI assigned
Sep 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Authorized official

Name
Kathie Armstrong
Title
Director of Credentialing
Phone
(502) 254-8501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X IN Primary

Addresses

Primary practice location

1240 Veterans Pkwy
Suite 100
Clarksville, IN 47129-2394

Mailing address

1240 Veterans Pkwy
Suite 100
Clarksville, IN 47129-2394
Phone (812) 284-2701

National Provider Directory

National Provider Directory
Tax ID family
Mortenson Family Dental Center- Clarksville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1240 Veterans Pkwy
#100
Clarksville, IN 47129
Phone (812) 284-2701

NPI Registry JSON

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1407281868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 VETERANS PKWY",
            "address_2": "SUITE 100",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471292394",
            "telephone_number": "812-284-2701",
            "fax_number": "812-282-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 VETERANS PKWY",
            "address_2": "SUITE 100",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471292394",
            "telephone_number": "812-284-2701",
            "fax_number": "812-282-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL CENTER- CLARKSVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-04",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "KATHIE",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "502-254-8501"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.