Oral Surgery Group of Middletown, PLLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

7229 Issued in KY

Legal business name

ORAL SURGERY GROUP OF MIDDLETOWN, PLLC

Practice address

134 Evergreen Rd
Middletown, KY 40243-1487

Phone

(502) 410-1702

NPI assigned

Apr 6, 2010

Organization subpart

No

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) 854-8501

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Practitioners 5

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

• Maneesh Mohan, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Louisville, KY
  • NPI 1154310985
  Medicare reassignment NPD
• Alexander Musser

  • Oral and Maxillofacial Surgery (Dentist)
  • Louisville, KY
  • NPI 1053756502
  Medicare reassignment NPD
• David Naselsker, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Louisville, KY
  • NPI 1790944106
  Medicare reassignment NPD
• Stephen H Sutley, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Fairbanks, AK
  • NPI 1124030085

  KY

  Medicare reassignment NPD
• Brent W Mortenson, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Louisville, KY
  • NPI 1356369169
  Medicare reassignment

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1497070148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437169",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402537169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 EVERGREEN RD",
            "city": "MIDDLETOWN",
            "state": "KY",
            "postal_code": "402431487",
            "telephone_number": "502-410-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY GROUP OF MIDDLETOWN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-06",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "KATHIE",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "502-854-8501"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "7229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mortenson Family Dental
• Jeffery Mortenson, DMD
• Michael Campbell Mullen, H.I.S.
• Justin L Nierengarten
• Megan Oleksa, PTA
• Dawn M Pennington, APRN
• Periodontic & Endodontic Services
• Long Phan
• Kylie Rae Poremba, PHARMD
• Powerback Rehabilitation LLC

• Oral and Maxillofacial Surgery Clinic/Center in Middletown, KY
• Providers in Middletown, KY by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.