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DR. RYAN M. DIEPENBROCK D.D.S. NPI 1942399159


NPI Information

NPI: 1942399159
Provider Name: DR. RYAN M. DIEPENBROCK, D.D.S.
Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
7845 CARNEGIE BLVD STE A
FORT WAYNE, IN
ZIP 46804
Phone: (260) 423-2340
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DR. Ryan M. Diepenbrock, D.D.S. is an oral maxillofacial surgery in Fort Wayne, IN with 19 years of experience. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. DR. Ryan M. Diepenbrock, D.D.S. NPI is 1942399159. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: OHIO STATE UNIVERSITY COLLEGE OF DENTISTRY
Graduation Year:2005

The provider's business location address is:

7845 CARNEGIE BLVD STE A
FORT WAYNE, IN
ZIP 46804-792
Phone: (260) 423-2340

The NPI 1942399159 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 10/12/2006 and was last updated on 10/9/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial Surgery30-022164OHIONo
2204E00000XOral & Maxillofacial Surgery63091CALIFORNIANo
3204E00000XOral & Maxillofacial Surgery12012587AINDIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.