Mortenson Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MORTENSON FAMILY DENTAL

Practice address

2441 State St
New Albany, IN 47150-4962

Phone

(812) 941-8500

Fax

(812) 944-1602

NPI assigned

Aug 31, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Owen Wayne Mortenson, DMD

Title

Gen Dentist/Owner

Phone

(502) 245-8627

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477665156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N EVERGREEN RD",
            "address_2": "SUITE 102",
            "city": "MIDDLETOWN",
            "state": "KY",
            "postal_code": "402431487",
            "telephone_number": "502-245-7103",
            "fax_number": "502-253-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 STATE ST",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504962",
            "telephone_number": "812-941-8500",
            "fax_number": "812-944-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORTENSON",
        "authorized_official_first_name": "OWEN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "GEN DENTIST/OWNER",
        "authorized_official_telephone_number": "502-245-8627",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabine E Moore, PT
• Thearsa Ann Moore
• Emily Anne Morgan-Smitley, ED.S., NCSP
• Sophia Isabella Morones
• Clinton Wayne Morris, PT, DPT
• Caitlin Moser, COTA/L
• Madeline Moses, PHARMD
• Steven R. Mosley, D. P. M.
• Donna Ann Moss, ARNP
• Michelle Lynn Moure, DMD

• Dental Clinic/Center in New Albany, IN
• Providers in New Albany, IN by specialty
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.