Mortenson Family Dental Center - Versailles, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MORTENSON FAMILY DENTAL CENTER - VERSAILLES, PLLC

Practice address

217 N Main St
Versailles, KY 40383-1266

Phone

(859) 873-0565

NPI assigned

May 22, 2014

Last updated

May 22, 2014By 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

Steve James

Title

Cfo

Phone

(502) 254-8504

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400716800000",
    "number": "1740692938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 EVERGREEN RD",
            "address_2": "SUITE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431487",
            "telephone_number": "502-254-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 N MAIN ST",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831266",
            "telephone_number": "859-873-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL CENTER - VERSAILLES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Versailles, KY
• Providers in Versailles, 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 May 22, 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.