DR. DAVID R. MORTENSEN (NPI# 1629281134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629281134 |
| Entity Type | Individual |
| Full Name | DR. DAVID R. MORTENSEN |
| Credential | D.M.D. |
| Practice Address |
355 Greenleaf Ave Suite A Park City IL 60085-5708 |
| Mailing Address |
2013 Greystem Cir Apt #207 Gurnee IL 60031-9336 |
| Practice Telephone | 8472444455 |
| Mailing Telephone | 8472444455 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518024520 | David Mortensen | Surgery | 800 Mercy Dr Ste 220, Council Bluffs, IA 51503-3128 | 2007-01-02 |
| 1023002581 | David H. Mortensen | Chiropractor | 3043 Foothill Blvd, Suite 8, La Crescenta, CA 91214-2715 | 2005-09-09 |
| 1871590430 | David D Mortensen | Optometrist | 1184 N. Main St, Crown Point, IN 46307 | 2005-06-28 |
| 1457584120 | David Mortensen | Pharmacist | 1311 N Mildred Rd, Cortez, CO 81321-2231 | 2009-08-28 |
| Street Address |
355 GREENLEAF AVE SUITE A |
| City | PARK CITY |
| State | IL |
| Zip Code | 60085-5708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316150048 | William G Dracos | Dentist | 355 Greenleaf Ave, Suite A, Park City, IL 60085-5708 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285189 | Allison Rose Matuszewski | Speech-Language Pathologist | Robbie M. Lightfoot, 1721 N Mcaree Rd, Waukegan, IL 60085 | 2019-09-23 |
| 1164985602 | Kristin Kaprak | Speech-Language Pathologist | Thomas Jefferson Middle School, 600 S. Lewis, Waukegan, IL 60085 | 2019-04-11 |
| 1861972317 | Mitchum Smith | Student in an Organized Health Care Education/Training Program | 2025 Washington Street, Waukegan, IL 60085 | 2018-08-15 |
| 1447702998 | Rachel Martinez | Registered Nurse | 3002 Grand Ave., Waukegan, IL 60085 | 2016-11-01 |
| 1831649250 | Kenneth Caples | Specialist/Technologist | 211 S County St, Waukegan, IL 60085 | 2016-10-10 |
| 1033666490 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 671 S. Lewis Ave., Waukegan, IL 60085 | 2016-09-02 |
| 1285007757 | Michael Moore | Counselor | 1113 Greenwood Ave, Waukegan, IL 60085 | 2015-11-05 |
| 1740656503 | Emperatriz Guerra | Counselor | 329 N. Genesee Street, Waukegan, IL 60085 | 2015-08-17 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1922406354 | Ebele Okonkwor | Nurse Anesthetist, Certified Registered | 1324 N. Sheridan, Waukegan, IL 60085 | 2014-12-17 |
| Find all providers in zip 60085 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629426234 | S Scott Kimche Dds Inc | Dentist | 2053 Sidewinder Dr, Park City, UT 84060-7323 | 2016-05-25 |
| 1538538657 | Pamela Hilbert | Dentist | 1830 Prospector Ave., Park City, UT 84060 | 2015-09-18 |
| 1609124767 | Robert Kenny Gildner | Dentist | 355 South Greanleaf Avenue, Suite A, Park City, IL 60085-5708 | 2012-08-21 |
| 1598996373 | Milagros Galvez Dds PC | Dentist | 355 Greenleaf St Ste E, Park City, IL 60085-5708 | 2009-07-28 |
| 1184888315 | Cody Michael Calderwood | Dentist | 1600 Snow Creek Dr Ste A, Park City, UT 84060 | 2008-07-16 |
| 1962666529 | Russell Smith | Dentist | 6415 Business Park Loop Rd Ste J, Park City, UT 84098-6218 | 2008-07-14 |
| 1043478217 | Ashley G. Bailey | Dentist | 1526 Ute Blvd, Suite 212, Park City, UT 84098-7522 | 2008-05-23 |
| 1427220250 | Milagritos Edith Caghan | Dentist | 355 Greenleaf Ave Ste E, Park City, IL 60085-5708 | 2008-04-01 |
| 1346452356 | Marc B Mckee | Dentist | 1830 Prospector Ave, Park City, UT 84060-7319 | 2007-05-03 |
| 1114148509 | Pinebrook Dental Group | Dentist | 3080 Pinebrook Rd, Suite 2000, Park City, UT 84098-5422 | 2007-05-01 |
| Find all providers in PARK CITY | ||||
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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.