FORT WAYNE ENDODONTICS (NPI# 1083265433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083265433 |
| Entity Type | Organization |
| Organization Name | FORT WAYNE ENDODONTICS |
| Practice Address |
9407 Illinois Rd Fort Wayne IN 46804 |
| Practice Telephone | 2604365772 |
| Practice Fax Number | 2604365779 |
| Mailing Telephone | 2604365772 |
| Mailing Fax Number | 2604365779 |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-09-26 |
| Authorized Official Name | DR. JASON P GLASSLEY (PRESIDENT) |
| Authorized Official Telephone | 2604365772 |
| Authorized Official Credential | DDS, MSD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers |
| Street Address |
9407 ILLINOIS RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| 1053776344 | Tiane Bianski | Dietitian, Registered | 6322 Farmswood Drive Apt 1b, Fort Wayne, IN 46804 | 2015-12-31 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679735898 | Jason P Glassley | Dentist | 5718 Coventry Ln, Fort Wayne, IN 46804-7141 | 2008-06-29 |
| 1629141387 | James W Fisher | Dentist | 4640 W Jefferson Blvd, Fort Wayne, IN 46804-6826 | 2006-11-17 |
| 1669589941 | Root Canal Specialty Services Inc | Dentist | 4636 W Jefferson Blvd, Fort Wayne, IN 46804 | 2006-08-24 |
| 1821104985 | Burton D K Brown | Dentist | 1220 Medical Park Drive, Building # 4, Fort Wayne, IN 46825 | 2006-08-22 |
| 1942354055 | Thomas G Oldag | Dentist | 4640 W Jefferson Blvd, Fort Wayne, IN 46804-6826 | 2007-01-23 |
| 1285788380 | Dennis J Zent | Dentist | 4640 W Jefferson Blvd, Fort Wayne, IN 46804-6826 | 2007-01-23 |
| 1417001546 | Ned A Warner | Dentist | 4640 W Jefferson Blvd, Fort Wayne, IN 46804-6826 | 2007-01-23 |
| 1528112562 | Endodontic Associates, Inc. | Dentist | 4640 W Jefferson Blvd, Fort Wayne, IN 46804-6826 | 2007-01-23 |
| 1407933427 | Robert Todd Mabry | Dentist | 4636 W Jefferson Blvd, Fort Wayne, IN 46804-6826 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255954913 | Adam B Broady Dds Msd & Associates LLC | Dentist | 9002 N Meridian St Ste 201, Indianapolis, IN 46260-5350 | 2020-05-28 |
| 1891322558 | Core Endodontics | Dentist | 2206 State St Ste 100, New Albany, IN 47150-4952 | 2020-03-24 |
| 1356816037 | West Indy Pippin Dental PC | Dentist | 8252 Rockville Rd, Indianapolis, IN 46214-3113 | 2018-10-09 |
| 1992299689 | East Washington Street Dental Indy, In, PC | Dentist | 9972 E Washington St, Indianapolis, IN 46229-3040 | 2018-06-18 |
| 1962940254 | Dcp of Indiana (castleton Square), P.C. | Dentist | 17535 Terry Lee Crossing, 200-b, Noblesville, IN 46060-2476 | 2017-02-07 |
| 1447559166 | Kool Smiles In-3, PC | Dentist | 3701 S Main St Ste A150, Elkhart, IN 46517-3140 | 2011-03-21 |
| 1780983726 | Kool Smiles In-3, PC | Dentist | 4315 Commerce Dr, Suite 310, Lafayette, IN 47905-3822 | 2011-03-16 |
| 1306072814 | Ashleigh Marie Rexford | Dentist | 3750 Guion Rd Ste 280, Indianapolis, IN 46222-1696 | 2009-06-10 |
| 1588810980 | Northside Endodontics, PC | Dentist | 1400 S Pilgrim Blvd, Yorktown, IN 47396-9250 | 2008-08-18 |
| 1053513283 | Karen Rose Kamer | Dentist | 8489 Fishers Center Dr, Fishers, IN 46038-2318 | 2007-06-01 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
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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.