1. Home
  2. Directory
  3. Indiana
  4. Fort Wayne
  5. Dentist
  6. NPI Profile

IPFW DENTAL HYGIENE CLINIC
NPI 1053512004
Dentist in Fort Wayne, IN

Active since May 29, 2007CLIA Certified · 2 labs
2101 EAST COLISEUM BOULEVARD, NEFF HALL ROOM 109, FORT WAYNE, IN 46805(260) 481-6575(260) 481-4162 Get Directions Write a Review

NPPES record last updated: August 2, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ipfw Dental Hygiene Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IPFW DENTAL HYGIENE CLINIC (NPI 1053512004) is a healthcare organization registered as a dentist in Fort Wayne, Indiana and active in the NPI registry since May 2007. The organization holds 2 active CLIA laboratory certificates and lists Joan M Vaughan, Director Hipaa Privacy Compliance, as its authorized official.

NPPES Registry Identity

NPI1053512004
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NamePURDUE UNIVERSITY
Location Address2101 EAST COLISEUM BOULEVARD, NEFF HALL ROOM 109Fort Wayne, IN 46805-1499
Mailing Address601 Stadium Mall DriveWest Lafayette, IN 47907-2052 · (765) 496-1927 · Fax (765) 496-1227
Phone(260) 481-6575
Fax(260) 481-4162
Organization SubpartYes
Authorized OfficialJoan M VaughanDirector Hipaa Privacy Compliance · (765) 496-1927
Enumeration DateMay 29, 2007
Last NPPES UpdateAugust 2, 2022
NPPES CertifiedAugust 2, 2022
✔ NPI 1053512004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
2101 EAST COLISEUM BOULEVARD, Fort Wayne, IN 46805
Open in Google Maps ↗

Other Names 1

Doing Business AsIpfw Dental Hygiene Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 15D0701130

Purdue University Student Health · West Lafayette, IN
Active · expires Oct 29, 2027
CLIA Number15D0701130
Laboratory TypeSchool/Student Health Service
Certificate Effective DateOctober 30, 2025
Certificate Expiration DateOctober 29, 2027
Laboratory DirectorDavid A. Gay
Laboratory Phone(765) 494-1720
Laboratory LocationPurdue University Student Health601 Stadium Mall Dr, West Lafayette, IN 47907
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 15D2182692

Purdue University Pharmacy · West Lafayette, IN
Active · expires Apr 23, 2028
CLIA Number15D2182692
Laboratory TypePharmacy
Certificate Effective DateApril 24, 2026
Certificate Expiration DateApril 23, 2028
Laboratory DirectorTrexie Rudd
Laboratory Phone(765) 494-1374
Laboratory LocationPurdue University Pharmacy575 Stadium Mall Drive, Room 118, West Lafayette, IN 47907
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Purdue University's NPI number?

The NPI number for Purdue University is 1053512004. It was assigned to this organization in the NPPES registry on May 29, 2007. The provider is doing business as Ipfw Dental Hygiene Clinic.

Where is Purdue University located?

Purdue University is located at 2101 East Coliseum Boulevard Neff Hall Room 109, Fort Wayne, IN 46805. The listed phone number is (260) 481-6575.

What is Purdue University's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Does Purdue University hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Purdue University was last updated on August 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.