FAMILIA DENTAL FORT WAYNE PLLC (NPI# 1467792663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467792663 |
| Entity Type | Organization |
| Organization Name | FAMILIA DENTAL FORT WAYNE PLLC |
| Practice Address |
5328 Coldwater Rd Fort Wayne IN 46825-5445 |
| Mailing Address |
2050 E Algonquin Rd 610 Schaumburg IL 60173-4144 |
| Practice Telephone | 8889884066 |
| Practice Fax Number | 8474967603 |
| Mailing Telephone | 8889884066 |
| Mailing Fax Number | 8474967603 |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2013-02-25 |
| Authorized Official Name | DR. KOUSHAN AZAD (PRESIDENT) |
| Authorized Official Telephone | 8889884066 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | FAMILIA DENTAL FORT WAYNE PLLC | 5328 Coldwater Rd, Fort Wayne, IN 46825-5445 |
| Street Address |
5328 COLDWATER RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-5445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962020495 | Amruta Shirbhate | Dentist | 5328 Coldwater Rd, Fort Wayne, IN 46825-5445 | 2020-07-10 |
| 1427672567 | Satya Kakarala | Dentist | 5328 Coldwater Rd, Fort Wayne, IN 46825-5445 | 2020-06-04 |
| 1891345955 | Sandeep Pasumarthy | Dentist | 5328 Coldwater Rd, Fort Wayne, IN 46825-5445 | 2019-09-19 |
| 1831750215 | Satish Kumar Gujjarlapudi | Dentist | 5328 Coldwater Rd, Fort Wayne, IN 46825-5445 | 2019-06-26 |
| 1154833895 | Preetinder Sidhu | Dentist | 5328 Coldwater Rd, Fort Wayne, IN 46825-5445 | 2017-11-03 |
| 1497104863 | Waseem Mohiuddin | Dentist | 5328 Coldwater Rd, Fort Wayne, IN 46825-5445 | 2016-06-07 |
| 1033593587 | Geethadevi Koneru | Dentist | 5328 Coldwater Rd, Fort Wayne, IN 46825-5445 | 2015-07-15 |
| 1922415561 | Alysha R Moll | Dentist | 5328 Coldwater Rd, Fort Wayne, IN 46825-5445 | 2014-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679186258 | James Patrick Thompson | Dentist | 5909 Wheelock Rd Ste 102, Fort Wayne, IN 46835-9258 | 2020-08-25 |
| 1295357481 | Sycamore Hills Dentistry | Dentist | 10082 Illinois Rd, Fort Wayne, IN 46804-5772 | 2020-05-11 |
| 1699324103 | Phillip M. Mckean Professional Corporation | Dentist | 6605 E State Blvd Ste 7, Fort Wayne, IN 46815-7036 | 2019-09-06 |
| 1598322083 | Charles Chase Ellinwood | Dentist | 5725 Maplecrest Rd Ste 1, Fort Wayne, IN 46835-4937 | 2019-05-21 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1821582172 | Jacob Yager | Dentist | 9830 Auburn Rd Ste 101, Fort Wayne, IN 46825-2464 | 2018-06-20 |
| 1740772656 | Colleen Rose Allen | Dentist | 10213 Dupont Circle Dr W, Fort Wayne, IN 46825-1656 | 2018-06-06 |
| 1407360910 | Grace Xinxing Clark | Dentist | 4716 Illinois Rd Ste 101, Fort Wayne, IN 46804-5123 | 2017-11-20 |
| 1578959375 | Ronald L Rumbaugh Dds PC | Dentist | 10506 Coldwater Rd, Fort Wayne, IN 46845-1235 | 2015-04-09 |
| 1619388063 | Familia Dental Spfw Pllc | Dentist | 100 E Pettit Ave, 1a, Fort Wayne, IN 46806-3003 | 2014-05-19 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
Please comment or provide details below to improve the information on FAMILIA DENTAL FORT WAYNE PLLC.
| 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.