Mortenson Family Dental Center - Prospect PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MORTENSON FAMILY DENTAL CENTER - PROSPECT PLLC

Practice address

9219 US Highway 42
Prospect, KY 40059-8857

Phone

(502) 228-2709

Fax

(502) 228-9884

NPI assigned

Sep 11, 2006

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) 254-8501

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Matthew Mortenson, DMD

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1245347640
  NPD (past)

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1588768758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9219 US HIGHWAY 42",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400598857",
            "telephone_number": "502-228-2709",
            "fax_number": "502-228-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9219 US HIGHWAY 42",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400598857",
            "telephone_number": "502-228-2709",
            "fax_number": "502-228-9884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL CENTER - PROSPECT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2015-04-14",
        "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": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Ann Miller
• Sarah Morgan Peterson Mitchell, D.M.D.
• Allison Leigh Montgomery
• Vicki Moore, APRN, FNP-BC
• Cindy Jones Morgan, OTA
• Mary Jo Mueller
• Caroline Blincoe Murr
• Tracy Sue Murray, OT
• Rachael Myrks-Brewer
• Irene Nagaraj, LCSW

• Dental Clinic/Center in Prospect, KY
• Providers in Prospect, 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 Apr 14, 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.