DR. ROBERT LOUIS KETCHAM (NPI# 1841317518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841317518 |
| Entity Type | Individual |
| Full Name | DR. ROBERT LOUIS KETCHAM |
| Credential | D.D.S., M.S.D |
| Practice Address |
1120 E Dupont Rd Fort Wayne IN 46825-1556 |
| Practice Telephone | 2604970497 |
| Practice Fax Number | 2604894853 |
| Mailing Telephone | 2604970497 |
| Mailing Fax Number | 2604894853 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2008-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
12006504A | IN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982611141 | Robert Edward Ketcham | Psychiatry & Neurology | 5225 Connecticut Ave. Nw, #404, Washington, DC 22101-1813 | 2006-08-01 |
| Street Address |
1120 E DUPONT RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-1556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396858957 | Orthodontic Specialty Services, Inc. | Dentist | 1120 E Dupont Rd, Fort Wayne, IN 46825-1556 | 2006-08-17 |
| 1235282138 | Eugene L Dellinger | Dentist | 1120 E Dupont Rd, Fort Wayne, IN 46825-1556 | 2007-01-22 |
| 1508970088 | Eric Lee Dellinger | Dentist | 1120 E Dupont Rd, Fort Wayne, IN 46825-1556 | 2006-08-19 |
| 1952415325 | Aron E Dellinger | Dentist | 1120 E Dupont Rd, Fort Wayne, IN 46825-1556 | 2006-08-19 |
| 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 | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174627749 | Gary Lynn Gotsch | Dentist | 4205 Hobson Ct, Fort Wayne, IN 46815-8648 | 2006-09-12 |
| 1447713219 | Fort Wayne Prosthodontics, Inc. | Dentist | 4205 Hobson Ct, Fort Wayne, IN 46815-8648 | 2019-04-09 |
| 1578732020 | Gary L. Gotsch Dds Msd | Dentist | 4205 Hobson Ct, Fort Wayne, IN 46815-8648 | 2008-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780208884 | Prosthodontics of Central Indiana | Dentist | 11405 N Penn St Ste 110, Carmel, IN 46032-6905 | 2020-06-04 |
| 1962068502 | Karina Pezo Shirley | Dentist | 2001 W Washington St Ste B2, Indianapolis, IN 46222-4549 | 2019-05-18 |
| 1275039497 | Julianne Manzo Sotomil | Dentist | 1121 W Michigan St # S312, Indianapolis, IN 46202-5211 | 2018-04-05 |
| 1447638648 | Kamolphob Phasuk | Dentist | 1121 W Michigan St Rm 313, Indianapolis, IN 46202-5521 | 2015-05-08 |
| 1750799565 | Alexandra Polus | Dentist | 1549 S Court St Ste B, Crown Point, IN 46307-4809 | 2014-07-24 |
| 1073929832 | Tyler Jeffrey Thomas | Dentist | 370 Medical Dr Ste B, Carmel, IN 46032-2971 | 2014-07-01 |
| 1770994238 | Ankit Patel | Dentist | 5770 Noble Dr, Indianapolis, IN 46234-7725 | 2014-05-17 |
| 1902032030 | Kellie Michelle Schaub | Dentist | 370 Medical Dr., Ste B, Carmel, IN 46032 | 2009-06-03 |
| 1083852669 | Roland S. Outarsingh | Dentist | 548 Ridge Rd, Suite G, Munster, IN 46321-1649 | 2009-02-04 |
| 1609031335 | Michael Loren Drone | Dentist | 809 Wall St Ste B, Valparaiso, IN 46383-2571 | 2008-07-22 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
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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.