Jeffery Mortenson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7480 Issued in KY

Practice address

11708 Main St
Middletown, KY 40243-1426

Phone

(502) 245-8627

Fax

(502) 245-9395

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Mortenson Family Dental

  • Dental Clinic/Center
  • Middletown, KY
  • NPI 1760593602
  NPD (past)
• Periodontic & Endodontic Services

  • Dental Clinic/Center
  • Middletown, KY
  • NPI 1609054584
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962519355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11708 MAIN ST",
            "city": "MIDDLETOWN",
            "state": "KY",
            "postal_code": "402431426",
            "telephone_number": "502-245-8627",
            "fax_number": "502-245-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11708 MAIN ST",
            "city": "MIDDLETOWN",
            "state": "KY",
            "postal_code": "402431426",
            "telephone_number": "502-245-8627",
            "fax_number": "502-245-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSON",
        "first_name": "JEFFERY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med 1St of Middletown, Inc.
• Lucie A Meffert, APRN
• Middletown Family Chiropractic
• Danielle Nicole Morris, PHARMD
• Mortenson Family Dental
• Michael Campbell Mullen, H.I.S.
• Justin L Nierengarten
• Megan Oleksa, PTA
• Oral Surgery Group of Middletown, PLLC
• Dawn M Pennington, APRN

• All providers in Middletown, KY
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.