Mortenson Family Dental Center-Highlands PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MORTENSON FAMILY DENTAL CENTER-HIGHLANDS PLLC

Practice address

2105 Weber Ave
Louisville, KY 40205-2110

Phone

(502) 473-2011

Fax

(502) 473-2013

NPI assigned

Sep 29, 2008

Organization subpart

No

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

Authorized official

Name

Steve James

Title

Cfo

Phone

(502) 254-8504

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Blair Brown

  • Dentist
  • Louisville, KY
  • NPI 1821224882
  NPD (past)
• Tyson Perrero, DMD

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1861629941
  NPD (past)

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1497905244",
    "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",
            "telephone_number": "502-254-8501",
            "fax_number": "502-805-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 WEBER AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052110",
            "telephone_number": "502-473-2011",
            "fax_number": "502-473-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL CENTER-HIGHLANDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-29",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8504"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100278400",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mortenson Family Dental Center - Jeffersontown Central, PLLC
• Mortenson Family Dental Center Hilliview-Okolona PLLC
• Mortenson Family Dental Center- Springhurst PLLC
• Mortenson Family Dental Center-Dupont,PLLC
• Mortenson Family Dental Center-Forest Green, PLLC
• Mortenson Family Dental Center-Jeffersontown, PLLC
• Mortenson Family Dental Center-Valley Station
• Brent W Mortenson, DMD
• Kate Lindsey Mortenson, DMD
• Matthew Mortenson, DMD

• Dental Clinic/Center in Louisville, KY
• Providers in Louisville, KY by specialty
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.