DR. BRIAN STEVEN MORTENSON (NPI# 1083161665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083161665 |
| Entity Type | Individual |
| Full Name | DR. BRIAN STEVEN MORTENSON |
| Credential | DMD |
| Practice Address |
36014 Wratten Ave. Fort Hood TX 76544 |
| Mailing Address |
6895 S Captiva Cv Cottonwood Heights UT 84121-3473 |
| Practice Telephone | 2542867401 |
| Mailing Telephone | 9288302763 |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2020-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 32124 | TX | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
11672604-9922 | UT | Dental Providers |
| Street Address |
36014 WRATTEN AVE. |
| City | FORT HOOD |
| State | TX |
| Zip Code | 76544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124626429 | Gilberto Rolando Nunez | Dental Hygienist | Dentac Fort Hood, 68th Street Bldg. 4431, Fort Hood, TX 76544 | 2020-10-09 |
| 1184236895 | Christina Belousov | Dentist | 14351 Battalion Ave, Apo, AA 76544 | 2020-08-24 |
| 1598377095 | Stephen Doh | Dentist | 23rd St &, Old Battalion Ave, Fort Hood, TX 76544 | 2020-08-18 |
| 1265041602 | Jamie Gregory | Registered Nurse | Building 33003 Battalion Ave, Fort Hood, TX 76544 | 2020-07-30 |
| 1013525559 | Danielle Robbins | Social Worker | 2255 761st Tank Battalion, Fort Hood, TX 76544 | 2020-07-21 |
| 1811530397 | Keven Faust | Physician Assistant | Carl R Darnell Army Medical Center, 36065 Sante Fe Ave, Fort Hood, TX 76544 | 2019-10-28 |
| 1760024483 | Whitney C Weatherall | Licensed Vocational Nurse | 5458 Hughes St Unit 2, Fort Hood, TX 76544 | 2019-10-14 |
| 1982255436 | Rojalina Nayak | Dentist | Building 4250 Clear Creek Road, Ste #213, Fort Hood, TX 76544 | 2019-09-26 |
| 1730735770 | Kai Steven Hatch | Dentist | 72nd and Support Building 33026, 1st Medical Brigade, Apo, AA 76544 | 2019-08-15 |
| 1881247864 | Melissa Ann Marcelli-flint | Social Worker | 21011 Old Ironsides Avenue, Fort Hood, TX 76544 | 2019-07-19 |
| Find all providers in zip 76544 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558510412 | Sheteka Kym Ross-goodlett | Dentist | Bldg 4250 Clear Creek Rd Suite 213, Fort Hood, TX 76544 | 2008-09-16 |
| 1659333854 | Manuel Marien Jr. | Dentist | 4431 68th Street, Hq, Usa Dentac, Fort Hood, TX 76544 | 2006-04-04 |
| 1285945089 | Kristofer Paul Sivanich | Dentist | 4431 68th St, Fort Hood, TX 76544-5042 | 2010-06-25 |
| 1881790376 | Tyrus Neapolis Hatcher | Dentist | 4431 68th Street, Fort Hood Dental Activity Credentials Office, Fort Hood, TX 76544 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647454 | Memorial Dentistry for Kids Pllc | Dentist | 14090 Memorial Dr, Houston, TX 77079-6848 | 2020-10-20 |
| 1497362651 | Munal Dental Pllc | Dentist | 2921 N Fm 1417 Ste 100, Sherman, TX 75092-3559 | 2020-09-30 |
| 1467069880 | Unique Kids Pediatric Dentistry, Pllc | Dentist | 22118 Market Place Dr Ste 500, New Caney, TX 77357-2165 | 2020-09-29 |
| 1104438092 | Sarah Al Kukash | Dentist | 2536 Amherst St Ste A, Houston, TX 77005-3207 | 2020-08-20 |
| 1295344679 | Bulverde Dental Specialist Pllc | Dentist | 22103 Bulverde Rd Ste 108, San Antonio, TX 78259-1855 | 2020-07-30 |
| 1174132559 | Previcare, Pllc | Dentist | 2006 W Campbell Rd Ste 300, Garland, TX 75044-2315 | 2020-07-30 |
| 1386252088 | Saba Saleem Tareen | Dentist | 1503 Royal Ln, Colleyville, TX 76034-5585 | 2020-07-19 |
| 1306454178 | Susan Roberts Pediatric Dentistry Pllc | Dentist | 5411 Basswood Blvd Ste 201, Fort Worth, TX 76137-4479 | 2020-07-17 |
| 1316564990 | Ikids Pediatric Dentistry Lakewood, Pllc | Dentist | 2011 Abrams Parkway, Dallas, TX 75214 | 2020-06-30 |
| 1316563497 | Woodlands Pediatric Dentistry PC | Dentist | 4850 W Panther Creek Dr Ste 102, The Woodlands, TX 77381-3595 | 2020-06-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.