Pediatric Dentistry Inc in Fort Wayne - Pediatric Dentistry
Pediatric Dentistry Inc - NPI 1104859701
Pediatric Dentistry Inc is a Pediatric Dentistry in Fort Wayne, Indiana. Pediatric Dentistry Inc practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Pediatric Dentistry Inc is 1104859701. The last update date is 2020-08-22.
Pediatric Dentistry Inc's current location address is 7750 West Jefferson Blvd, Fort Wayne, Indiana. You can contact this provider via phone number 2604590903 and fax number 2604590673. The mailing address for Pediatric Dentistry Inc is 7750 West Jefferson Blvd, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pediatric Dentistry Inc |
|---|---|
| Address | 7750 West Jefferson Blvd, Fort Wayne, Indiana |
| Phone Number | 2604590903 |
| Fax Number | 2604590673 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Dawes Lee Wayne |
| Credentials | DDS |
| Telephone Number | 2604590903 |
NPI Number Detail
| NPI Number | 1104859701 |
|---|---|
| Provider Enumeration Date | 2006-07-08 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 7750 West Jefferson Blvd |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468044136 |
| Phone Number | 2604590903 |
| Fax Number | 2604590673 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 54000382A |
|
Definition: 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. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 104667 | IN | IND DEPT OF HEALTH CHILDR |
Post Comment/ Review Below
What is the unique identifier code issued to Pediatric Dentistry Inc by the Centers for Medicare & Medicaid Services?
The Pediatric Dentistry Inc has been assigned the NPI (National Provider Identifier) 1104859701. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Pediatric Dentistry Inc?
The Pediatric Dentistry Inc is physically situated at 7750 West Jefferson Blvd, in the city of Fort Wayne, state of IN, with the postal code 468044136.
What is Pediatric Dentistry Inc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Pediatric Dentistry Inc is Pediatric Dentistry, and the taxonomy code that classifies this field of practice is 1223P0221X.
When was the Pediatric Dentistry Inc's 1104859701 issued?
The Pediatric Dentistry Inc's 1104859701 was issued on 2006-07-08.
When was the information regarding Pediatric Dentistry Inc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Pediatric Dentistry Inc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2020-08-22.
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