MIDWEST ORAL AND MAXILLOFACIAL SURGERY P C
NPI 1558416883
Dentist - Oral and Maxillofacial Surgery in Fort Wayne, IN

Active since January 25, 2007
7230 ENGLE RD, SUITE 301, FORT WAYNE, IN 46804(260) 432-5566(260) 432-5567 Get Directions Write a Review

NPPES record last updated: March 26, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Midwest Oral And Maxillofacial Surgery P C NPPES

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

MIDWEST ORAL AND MAXILLOFACIAL SURGERY P C (NPI 1558416883) is a healthcare organization registered as an oral and maxillofacial surgery in Fort Wayne, Indiana and active in the NPI registry since January 2007. The organization lists Michael L Iczkovitz, President, as its authorized official.

NPPES Registry Identity

NPI1558416883
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameMIDWEST ORAL AND MAXILLOFACIAL SURGERY P C
Location Address7230 ENGLE RD, SUITE 301Fort Wayne, IN 46804-2209
Mailing Address3303 Trier RdFort Wayne, IN 46815-4768 · (260) 484-9990 · Fax (260) 484-6573
Fax(260) 432-5567
Organization SubpartNo
Authorized OfficialMichael L IczkovitzPresident · (260) 484-9990
Enumeration DateJanuary 25, 2007
Last NPPES UpdateMarch 26, 2009
NPI 1558416883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in IN · 54000677
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

7230 ENGLE RD, Fort Wayne, IN 46804

Other Identifiers 2

Medicaid200147450IN
Medicare ID-Type Unspecified924690IN · Medicare

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 5

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

Psychologist (Clinical)
7230 ENGLE RD, STE 304
FORT WAYNE, IN 46804
Medical Genetics (Clinical Genetics (M.D.))
7230 ENGLE RD
FORT WAYNE, IN 46804
Family Medicine
7230 ENGLE RD
FORT WAYNE, IN 46804
Nurse Practitioner (Family)
7230 ENGLE RD, SUITE 210
FORT WAYNE, IN 46804
Family Medicine
7230 ENGLE RD
FORT WAYNE, IN 46804

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 Midwest Oral And Maxillofacial Surgery P C's NPI number?

The NPI number for Midwest Oral And Maxillofacial Surgery P C is 1558416883. It was assigned to this organization in the NPPES registry on January 25, 2007.

Where is Midwest Oral And Maxillofacial Surgery P C located?

Midwest Oral And Maxillofacial Surgery P C is located at 7230 Engle Rd Suite 301, Fort Wayne, IN 46804. The listed phone number is (260) 432-5566.

What is Midwest Oral And Maxillofacial Surgery P C's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Midwest Oral And Maxillofacial Surgery P C was last updated on March 26, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.