Micah G. Mortensen, D.D.S., M.S.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

4726746-9921 Issued in UT

Practice address

6287 S Redwood Rd Ste 202
Salt Lake City, UT 84123-6655

Phone

(801) 262-3777

NPI assigned

Dec 15, 2006

Last updated

Jun 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Redwood Orthodontics

  dba Families First Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Taylorsville, UT
  • NPI 1437922465
  NPD
• Families First Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Stansbury Park, UT
  • NPI 1003689431
  NPD (past)
• Peter E. Paulos, DDS, Ms

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Salt Lake City, UT
  • NPI 1508014127
  NPD (past)
• Stansbury Park Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Stansbury Park, UT
  • NPI 1528385085
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1891857579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15359 W COLUMBINE DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853799190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6287 S REDWOOD RD STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841236655",
            "telephone_number": "801-262-3777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Country Club",
            "address_2": "Ste 104",
            "address_purpose": "LOCATION",
            "city": "Stansbury Park",
            "state": "UT",
            "postal_code": "840749602",
            "country_code": "US",
            "telephone_number": "435-579-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 S Market St Ste 125",
            "address_purpose": "LOCATION",
            "city": "West Valley City",
            "state": "UT",
            "postal_code": "841193617",
            "country_code": "US",
            "telephone_number": "801-966-6681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13825 S Redwood Rd",
            "address_purpose": "LOCATION",
            "city": "Bluffdale",
            "state": "UT",
            "postal_code": "840655222",
            "country_code": "US",
            "telephone_number": "801-515-5858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4651 W 13400 S",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "840966419",
            "country_code": "US",
            "telephone_number": "801-515-5858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "MICAH",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "4726746-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Lynn Mortensen, FNP
• Kelly Christine Mortensen, DPT
• Lori Mortensen
• Mercedes Longshaw Mortensen, AGNP-C
• Mia Mortensen, TRS, CTRS
• Shannon Mortensen
• Sharalynn Mortensen
• Spencer David Mortensen, O.D, F.A.A.O.
• Molly Mortier
• Amanda Dawn Morton

• Orthodontics and Dentofacial Orthopedics Dentistry in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.