Mortenson Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MORTENSON FAMILY DENTAL

Practice address

1430 Poplar Level Rd
Louisville, KY 40217-1345

Phone

(502) 636-0311

Fax

(502) 636-8424

NPI assigned

Aug 31, 2006

Last updated

Aug 22, 2020By 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

Dr. Owen Wayne Mortenson

Title

Gen. Dentist/Owner

Phone

(502) 636-0311

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Fuchs, DMD

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1548377674
  NPD (past)
• Sierra Brooke Nunn, DMD

  • General Practice Dentistry
  • Lexington, KY
  • NPI 1659903474
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790897882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 N EVERGREEN RD",
            "city": "MIDDLETOWN",
            "state": "KY",
            "postal_code": "402431487",
            "telephone_number": "502-245-7103",
            "fax_number": "502-253-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 POPLAR LEVEL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171345",
            "telephone_number": "502-636-0311",
            "fax_number": "502-636-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORTENSON",
        "authorized_official_first_name": "OWEN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "GEN. DENTIST/OWNER",
        "authorized_official_telephone_number": "502-636-0311",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmad Michael Morshedi, O.D.
• William Garrett Mortell, DO
• Alison Mortensen
• Mortenson Family Dental
• Mortenson Family Dental
• Mortenson Family Dental
• Mortenson Family Dental Center (engilman orthodontics)
• Mortenson Family Dental Center - Dixie at Rockford Lane, PLLC
• Mortenson Family Dental Center - Jeffersontown Central, PLLC
• Mortenson Family Dental Center Hilliview-Okolona PLLC

• 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 Aug 22, 2020; 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.