Mortenson Family Dental Center - Shelbyville PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MORTENSON FAMILY DENTAL CENTER - SHELBYVILLE PLLC

Practice address

130 Stonecrest Rd
Suite 101
Shelbyville, KY 40065-8126

Phone

(502) 633-1584

Fax

(502) 633-1509

NPI assigned

Aug 11, 2006

Last updated

Aug 18, 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

Stephen James

Title

Cfo

Phone

(502) 254-8504

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.

• Jessica Jane Eugenio, DMD

  • Dentist
  • Shelbyville, KY
  • NPI 1730160698
  NPD (past)
• Joseph A Koval, D.M.D.

  • General Practice Dentistry
  • Shelbyville, KY
  • NPI 1588675805
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408320000000",
    "number": "1952312118",
    "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",
            "telephone_number": "502-254-8501",
            "fax_number": "502-805-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 STONECREST RD",
            "address_2": "SUITE 101",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658126",
            "telephone_number": "502-633-1584",
            "fax_number": "502-633-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL CENTER - SHELBYVILLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2014-08-18",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEPHEN",
        "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": []
}

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

• Dental Clinic/Center in Shelbyville, KY
• Providers in Shelbyville, 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 18, 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.