Wayne Youth Dentistry, Llc

LBN: Wayne Youth Dentistry, Llc
Wayne Youth Dentistry, Llc is an health care organization with primary practice located at 7524 S Anthony Blvd , Fort Wayne IN 46816-2517. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Wayne Youth Dentistry, Llc can be contacted via phone (260) 441-8500, or through Stump, Jenell via phone (615) 750-0343.

Contact Information

Primary practice address
7524 S Anthony Blvd Fort Wayne IN 46816-2517
Phone: (260) 441-8500
Fax: (260) 441-0887
Website:
Map and Directions
Authorized official contact:
Name: Stump, Jenell
Phone: (615) 750-0343

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1356399182
LBN Legal business name Wayne Youth Dentistry, Llc
DBA Doing business as
Authorized official Stump, Jenell
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2006
Last updated Jul 9th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356399182 NPPES
Ohio MEDICAID 2619223
Ohio MEDICAID 200542880A

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