David Glen Mortenson, D.M.D., M.S.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

8016 Issued in AZ

Practice address

2208 S Barrington
Mesa, AZ 85209-5328

Phone

(480) 450-0829

NPI assigned

Aug 18, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1770898488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 S LINDSAY RD",
            "address_2": "SUITE 127",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852971503",
            "telephone_number": "480-450-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 S BARRINGTON",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852095328",
            "telephone_number": "480-450-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSON",
        "first_name": "DAVID",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-18",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "8016",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "KY",
            "license": "8995",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita W Morse
• Mona Morstein, N.D.
• Mort Mori
• Monique A Mort, LPC
• Katia Mortazavinia, D.M.D.
• Joyce C Morton, NP
• Mark Mosbacher, DVM
• Thomas A Moser, O.D.
• Rachel Moses
• Katherine Mosier

• Endodontics in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Endodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.