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WAYNE YOUTH DENTISTRY, LLC
NPI 1356399182
Dentist - General Practice in Fort Wayne, IN

Active since May 04, 2006
7524 S ANTHONY BLVD, FORT WAYNE, IN 46816(260) 441-8500(260) 441-0887 Get Directions Write a Review

NPPES record last updated: July 9, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wayne Youth Dentistry, Llc NPPES

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

WAYNE YOUTH DENTISTRY, LLC (NPI 1356399182) is a healthcare organization registered as a general practice in Fort Wayne, Indiana and active in the NPI registry since May 2006. The organization lists Jenell Stump, Manager, Licensing & Credentialing, as its authorized official.

NPPES Registry Identity

NPI1356399182
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameWAYNE YOUTH DENTISTRY, LLC
Location Address7524 S ANTHONY BLVDFort Wayne, IN 46816-2517
Mailing Address16 Arcade Unit 198747Nashville, TN 37219-1994 · (615) 750-0343 · Fax (615) 986-1705
Phone(260) 441-8500
Fax(260) 441-0887
Organization SubpartNo
Authorized OfficialJenell StumpManager, Licensing & Credentialing · (615) 750-0343
Enumeration DateMay 4, 2006
Last NPPES UpdateJuly 9, 2014
✔ NPI 1356399182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
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.
7524 S ANTHONY BLVD, Fort Wayne, IN 46816
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Other Identifiers 2

Medicaid2619223OH
Medicaid200542880AIN

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.

STEVEN RICHARD CLUTE DDS
Dentist (General Practice)
7524 S ANTHONY BLVD
FORT WAYNE, IN 46816
Allen County (260) 441-8500
JENNIFER LYNN TAYLOR DDS
Dentist (General Practice)
7524 S ANTHONY BLVD
FORT WAYNE, IN 46816
Allen County (260) 441-8500
CLUTE YOUTH DENTISTRY, INC.
Dentist (General Practice)
7524 S ANTHONY BLVD
FORT WAYNE, IN 46816
Allen County (260) 441-8500

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 Wayne Youth Dentistry, LLC's NPI number?

The NPI number for Wayne Youth Dentistry, LLC is 1356399182. It was assigned to this organization in the NPPES registry on May 4, 2006.

Where is Wayne Youth Dentistry, LLC located?

Wayne Youth Dentistry, LLC is located at 7524 S Anthony Blvd, Fort Wayne, IN 46816. The listed phone number is (260) 441-8500.

What is Wayne Youth Dentistry, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Wayne Youth Dentistry, LLC was last updated on July 9, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.