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BRENT W MORTENSON DMD
NPI 1356369169
Dentist - Oral and Maxillofacial Surgery in Louisville, KY

Active since July 18, 2006PECOS EnrolledAccepts Medicare Assignment
134 EVERGREEN RD, SUITE 103, LOUISVILLE, KY 40243(502) 410-1702(502) 244-0817 Get Directions Write a Review

NPPES record last updated: June 18, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Brent W Mortenson Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRENT W MORTENSON DMD (NPI 1356369169) is an individual oral and maxillofacial surgery provider in Louisville, Kentucky, licensed in Kentucky (7229) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Louisville School Of Dentistry (1993).

NPPES Registry Identity

NPI1356369169
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameBRENT W MORTENSONCredential: DMD
Location Address134 EVERGREEN RD, SUITE 103Louisville, KY 40243-1487
Mailing Address134 Evergreen Rd, Suite 103Louisville, KY 40243-1487 · (502) 410-1702 · Fax (502) 244-0817
Phone(502) 410-1702
Fax(502) 244-0817
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of DentistryGraduated 1993
Enumeration DateJuly 18, 2006
Last NPPES UpdateJune 18, 2014
✔ NPI 1356369169 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in KY · 7229
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedDentistTaxonomy 122300000X · License 7229 (KY)
Also ListedDentist · Pediatric DentistryTaxonomy 1223P0221X · License 7229 (KY)
Also ListedOral & Maxillofacial SurgeryTaxonomy 204E00000X · License 7229 (KY)
134 EVERGREEN RD, Louisville, KY 40243
Open in Google Maps ↗

Other Identifiers 8

Medicare PIN0574803KY
Medicare PIN0997502KY
Medicare PIN0047405KY
Medicaid60072295KY
Medicaid64072291KY
Medicare UPINU68878KY
Medicare PIN0047505KY
Medicare PIN0047608KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brent W Mortenson Dmd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7315954187
PECOS Enrollment IDI20060320000475
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40243 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. EMILY KAY HILLIARD DMD
Dentist
134 EVERGREEN RD, SUITE 200
LOUISVILLE, KY 40243
Jefferson County (502) 244-9595
DR. ZAINAB MUNAWER KHAN D.M.D
Dentist (General Practice)
134 EVERGREEN RD, STE 200
LOUISVILLE, KY 40243
Jefferson County (630) 926-1494
DR. RAMA L KAKARLAPUDI DMD
Dentist (General Practice)
134 EVERGREEN RD, SUITE 200
MIDDLETOWN, KY 40243
Jefferson County (502) 254-8500
ENGILMAN ORTHODONTICS PLLC
Clinic/Center (Dental)
134 EVERGREEN RD, SUITE 100
LOUISVILLE, KY 40243
Jefferson County (502) 253-2201
ORAL SURGERY GROUP OF MIDDLETOWN, PLLC
Clinic/Center (Oral and Maxillofacial Surgery)
134 EVERGREEN RD
MIDDLETOWN, KY 40243
Jefferson County (502) 410-1702
POOJA K REDDY DMD
Dentist (General Practice)
134 EVERGREEN RD, SUITE 200
LOUISVILLE, KY 40243
Jefferson County (502) 254-8514

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brent Mortenson's NPI number?

The NPI number for Brent Mortenson is 1356369169. It was assigned to this individual provider in the NPPES registry on July 18, 2006.

Where is Brent Mortenson located?

Brent Mortenson practices at 134 Evergreen Rd Suite 103, Louisville, KY 40243. The listed phone number is (502) 410-1702.

What is Brent Mortenson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Brent Mortenson enrolled in Medicare?

Yes. Brent Mortenson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Brent Mortenson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield and 9 other insurers list Brent Mortenson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brent Mortenson was last updated on June 18, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.