NPIMap

Organization Active NPI

Mortenson Family Dental Center - Jeffersontown Central, PLLC

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1497147383
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MORTENSON FAMILY DENTAL CENTER - JEFFERSONTOWN CENTRAL, PLLC
Practice address
10004 Taylorsville Rd
Louisville, KY 40299-3134
Phone
(502) 267-7736
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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

10004 Taylorsville Rd
Louisville, KY 40299-3134

Mailing address

10004 Taylorsville Rd
Louisville, KY 40299-3134
Phone (502) 267-7736

National Provider Directory

National Provider Directory

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": "1497147383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 TAYLORSVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402993134",
            "telephone_number": "502-267-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 TAYLORSVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402993134",
            "telephone_number": "502-267-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL CENTER - JEFFERSONTOWN CENTRAL, 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": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "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.