Mortenson Family Dental Center-Shelbyville East

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MORTENSON FAMILY DENTAL CENTER-SHELBYVILLE EAST

Practice address

502 Mount Eden Rd
Shelbyville, KY 40065-8871

Phone

(502) 633-1538

NPI assigned

Jul 16, 2010

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": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279238400000",
    "number": "1801109053",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 MOUNT EDEN RD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658871",
            "telephone_number": "502-633-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL CENTER-SHELBYVILLE EAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-07-16",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Lynn Moore, SLP
• Emily Moore
• Amy Michelle Morehead, APRN
• Tonya Morgan, BSN, RN
• Mortenson Family Dental Center - Shelbyville PLLC
• Lydia Tannis Mosher, OT/L
• Jazmyn Ciera Moss
• Natalie Mudd
• Allyson Mueller, PT, DPT
• Tiffanie Diane Mueller, DNP, APRN

• Clinic/Center in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.