Organization Active NPI

Mortenson Family Dental Center-Forest Green, PLLC

  • Dental Clinic/Center
  • Louisville, KY
National Provider Identifier
1972779445
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MORTENSON FAMILY DENTAL CENTER-FOREST GREEN, PLLC
Practice address
10031 Forest Green Blvd
Louisville, KY 40223-5119
Phone
(502) 412-7587
Fax
(502) 412-7066
NPI assigned
May 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Steve James
Title
Coo
Phone
(502) 254-8504

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

10031 Forest Green Blvd
Louisville, KY 40223-5119

Mailing address

PO Box 437169
Louisville, KY 40253-7169

National Provider Directory

National Provider Directory

Locations

2482 US Highway 227
Carrollton, KY 41008
Phone (502) 732-0333

10031 Forest Green Blvd
Louisville, KY 40223
Phone (502) 412-7587

10004 Taylorsville Rd
Louisville, KY 40299
Phone (502) 267-7736

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1972779445",
    "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": "10031 FOREST GREEN BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235119",
            "telephone_number": "502-412-7587",
            "fax_number": "502-412-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTENSON FAMILY DENTAL CENTER-FOREST GREEN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "502-254-8504"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.