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INDIANA PEDIATRIC DENTAL & ANESTHESIA LLC
NPI 1164016127
Dentist - Pediatric Dentistry in Fort Wayne, IN

Active since February 21, 2021
3030 LAKE AVE STE 15, FORT WAYNE, IN 46805(512) 902-9997 Get Directions Write a Review

NPPES record last updated: February 21, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Indiana Pediatric Dental & Anesthesia Llc NPPES

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

INDIANA PEDIATRIC DENTAL & ANESTHESIA LLC (NPI 1164016127) is a healthcare organization registered as a pediatric dentistry in Fort Wayne, Indiana and active in the NPI registry since February 2021. The organization lists Lucian Dan Boboia, Owner, as its authorized official.

NPPES Registry Identity

NPI1164016127
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameINDIANA PEDIATRIC DENTAL & ANESTHESIA LLC
Location Address3030 LAKE AVE STE 15Fort Wayne, IN 46805-5428
Mailing Address3030 Lake Ave Ste 15Fort Wayne, IN 46805-5428 · (512) 902-9997
Phone(512) 902-9997
Organization SubpartNo
Authorized OfficialLucian Dan BoboiaOwner · (512) 902-9997
Enumeration DateFebruary 21, 2021
NPPES CertifiedFebruary 21, 2021
✔ NPI 1164016127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
3030 LAKE AVE STE 15, Fort Wayne, IN 46805
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Other Identifiers 1

Other12010910AIN · State Of Indiana Dentistry Board

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

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LUCIAN DAN BOBOIA DDS
Dentist (Dentist Anesthesiologist)
3030 LAKE AVE STE 15
FORT WAYNE, IN 46805
Allen County (512) 902-9997
PROSPER HOLISTIC DENTISTRY LLC
Clinic/Center (Dental)
3030 LAKE AVE STE 15
FORT WAYNE, IN 46805
Allen County (260) 888-4130
DR. ALLYSON NICOLE FEASEL DDS
Dentist
3030 LAKE AVE STE 15
FORT WAYNE, IN 46805
Allen County (317) 607-7959

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 Indiana Pediatric Dental & Anesthesia LLC's NPI number?

The NPI number for Indiana Pediatric Dental & Anesthesia LLC is 1164016127. It was assigned to this organization in the NPPES registry on February 21, 2021.

Where is Indiana Pediatric Dental & Anesthesia LLC located?

Indiana Pediatric Dental & Anesthesia LLC is located at 3030 Lake Ave Ste 15, Fort Wayne, IN 46805. The listed phone number is (512) 902-9997.

What is Indiana Pediatric Dental & Anesthesia LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Indiana Pediatric Dental & Anesthesia LLC was last updated on February 21, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.