MORTENSON FAMILY DENTAL (NPI# 1730291493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730291493 |
| Entity Type | Organization |
| Organization Name | MORTENSON FAMILY DENTAL |
| Practice Address |
2005 S Highway 53 Lagrange KY 40031-9109 |
| Mailing Address |
134 N Evergreen Rd Suite 102 Middletown KY 40243-1487 |
| Practice Telephone | 5022250074 |
| Practice Fax Number | 5022250882 |
| Mailing Telephone | 5022457103 |
| Mailing Fax Number | 5022532202 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. OWEN WAYNE MORTENSON (GEN DENTIST/OWNER) |
| Authorized Official Telephone | 5022458627 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487757761 | Mortenson Family Dental | Clinic/Center | 110 N. Locust St, Carlisle, KY 40311 | 2006-09-05 |
| 1306949466 | Mortenson Family Dental | Clinic/Center | 1746 Highway 44 E, Shepherdsville, KY 40165-6131 | 2006-09-06 |
| 1790897882 | Mortenson Family Dental | Clinic/Center | 1430 Poplar Level Rd, Louisville, KY 40217-1345 | 2006-08-31 |
| 1881706547 | Mortenson Family Dental | Clinic/Center | 911 Palatka Rd, Louisville, KY 40214-3461 | 2006-08-31 |
| 1407968159 | Mortenson Family Dental | Clinic/Center | 8711 Old Bardstown Rd, Louisville, KY 40291-4435 | 2006-08-31 |
| 1760593602 | Mortenson Family Dental | Clinic/Center | 11708 Main St, Middletown, KY 40243-1426 | 2006-08-31 |
| 1477665156 | Mortenson Family Dental | Clinic/Center | 2441 State St, New Albany, IN 47150-4962 | 2006-08-31 |
| 1376655498 | Mortenson Family Dental | Clinic/Center | 5222 Dixie Hwy, Louisville, KY 40216-1704 | 2006-08-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | MORTENSON FAMILY DENTAL CENTER - CLARKSVILLE, LLC | 134 N Evergreed Rd Ste 200, Middletown, KY 40243 |
| Indiana Business Entities | MORTENSON FAMILY DENTAL CENTER - CORYDON LLC | 11801 Brinley Ave., Suite 100, Middletown, KY 40243 |
| Indiana Business Entities | MORTENSON FAMILY DENTAL CENTER - LAWRENCEBURG, LLC | 11801 Brinley Ave Ste 100, Middletown, KY 40243 |
| Indiana Business Entities | MORTENSON FAMILY DENTAL CENTER - NEW ALBANY, LLC | 11801 Brinley Ave, Suite 100, Middletown, KY 40243 |
| Street Address |
2005 S HIGHWAY 53 |
| City | LAGRANGE |
| State | KY |
| Zip Code | 40031-9109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720195969 | Todd Mortenson | Dentist | 2005 S Highway 53, Lagrange, KY 40031-9109 | 2006-08-24 |
| 1538262753 | Engileman Orthodontics | Clinic/Center | 2005 S Highway 53, Lagrange, KY 40031-9109 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723089 | Nancee L Berling | Registered Nurse | 1914 Miller Ln, La Grange, KY 40031 | 2018-06-06 |
| 1134643000 | Zachary Byrne | Dentist | 3108 S. Hwy 53, Lagrange, KY 40031 | 2017-08-01 |
| 1609399971 | Walgreen Co | Pharmacy | 408 Oldham Plaza, La Grange, KY 40031 | 2017-07-19 |
| 1447790886 | Carolyn Marie Burton | Speech-Language Pathologist | 4603 Timber Walk Ct., Lagrange, KY 40031 | 2017-03-05 |
| 1699145466 | Janet Frager | Nurse Practitioner | 1023 New Moody Ln Ste 101, La Grange, KY 40031 | 2015-10-05 |
| 1730559188 | Amanda Lynn Drawbaugh | Physical Therapist | Ascb Therapy, 4603 Timber Walk Ct., Lagrange, KY 40031 | 2015-09-29 |
| 1407250483 | Aaron Mangum | Specialist/Technologist | 2850 Jericho Road, Lagrange, KY 40031 | 2014-10-20 |
| 1073944500 | Tamara Thomas | Case Manager/Care Coordinator | 4121 Spencer Ct, Lagrange, KY 40031 | 2013-12-10 |
| 1669643854 | Alisa Marie Skinner | Physical Therapist | 618 Kentucky Ave, Lagrange, KY 40031 | 2008-03-17 |
| 1245410711 | Jennifer Lee Thomas | Nurse Practitioner | 1015 New Moody Lane, Lagrange, KY 40031 | 2007-11-13 |
| Find all providers in zip 40031 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538262753 | Engileman Orthodontics | Clinic/Center | 2005 S Highway 53, Lagrange, KY 40031-9109 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535810 | Norvell Family Dentistry Pllc | Clinic/Center | 821 W. Hwy 25w, Williamsburg, KY 40769 | 2020-10-15 |
| 1629696505 | Kauffmann and Sims Dentistry Pllc | Clinic/Center | 3935 Dupont Cir Ste A, Louisville, KY 40207-4824 | 2020-07-08 |
| 1841816824 | Lyon Family Dental | Clinic/Center | 252 Commerce St, Eddyville, KY 42038-8294 | 2020-06-24 |
| 1508487109 | Arrow Dental Pllc | Clinic/Center | 1107 Crown Pointe Dr Ste 210, Elizabethtown, KY 42701-7281 | 2020-05-05 |
| 1831710698 | Arrow Dental Pllc | Clinic/Center | 25 E High St Ste 2, Mt Sterling, KY 40353-1267 | 2020-05-04 |
| 1699396440 | Arrow Dental Pllc | Clinic/Center | 2560 Bypass Rd Ste 2, Winchester, KY 40391-2387 | 2020-05-04 |
| 1922629773 | Arrow Dental Pllc | Clinic/Center | 1080 Ben Ali Dr Ste A, Danville, KY 40422-8937 | 2020-05-04 |
| 1730700576 | Arrow Dental Pllc | Clinic/Center | 2505 Larkin Rd Ste 201, Lexington, KY 40503-3256 | 2020-05-04 |
| 1699394783 | Professional Dental Services of Kentucky Psc | Clinic/Center | 4814 Outer Loop Ste A, Louisville, KY 40219-3302 | 2020-04-09 |
| 1316579279 | Shannon P Johnson Dmd Pllc | Clinic/Center | 9510 Ormsby Station Rd Ste 203, Louisville, KY 40223-4083 | 2020-02-09 |
| 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.