NPIMap

Organization Active NPI

MFDC of Indiana, Inc

  • General Practice Dentistry
  • Scottsburg, IN
National Provider Identifier
1962065565
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MFDC OF INDIANA, INC
Practice address
1606 W McClain Ave
Scottsburg, IN 47170
Phone
(502) 254-8500
NPI assigned
Apr 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Jeff Reibel
Title
Cfo
Phone
(502) 254-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1606 W McClain Ave
Scottsburg, IN 47170

Mailing address

PO Box 437169
Louisville, KY 40253-7169

Other names 1

  • Mortenson Family Dental - Scottsburg Doing business as

National Provider Directory

National Provider Directory
Tax ID family
MFDC of Indiana Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

1606 W McClain Ave
Scottsburg, IN 47170
Phone (812) 414-4100

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1962065565",
    "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": "1606 W MCCLAIN AVE",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "47170",
            "telephone_number": "502-254-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MFDC OF INDIANA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-18",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "REIBEL",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mortenson Family Dental - Scottsburg",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mortenson Family Dental - Scottsburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scottsburg, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.