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DR. RYAN M. DIEPENBROCK D.D.S.
NPI 1942399159
Oral & Maxillofacial Surgery in Fort Wayne, IN

Active since October 12, 2006PECOS Enrolled
7845 CARNEGIE BLVD STE A, FORT WAYNE, IN 46804(260) 423-2340 Get Directions Write a Review

NPPES record last updated: November 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 25, 2025, Oct 9, 2019 (2 updates tracked since 2019).

About Dr. Ryan M. Diepenbrock D.d.s. NPPES

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

DR. RYAN M. DIEPENBROCK D.D.S. (NPI 1942399159) is an individual oral & maxillofacial surgery provider in Fort Wayne, Indiana, licensed in Indiana (12012587A) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Ohio State University College Of Dentistry (2005).

NPPES Registry Identity

NPI1942399159
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. RYAN M. DIEPENBROCKCredential: D.D.S.
Location Address7845 CARNEGIE BLVD STE AFort Wayne, IN 46804-5792
Mailing Address101 Bodin CirFairfield, CA 94535-1809 · (707) 423-7085
Phone(260) 423-2340
Sole ProprietorNo
Medical School CMSOhio State University College Of DentistryGraduated 2005
Enumeration DateOctober 12, 2006
Last NPPES UpdateNovember 25, 20252 updates tracked since enumeration
NPPES CertifiedNovember 25, 2025
✔ NPI 1942399159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
Licenses✔ Licensed in IN · 12012587A✔ Licensed in CA · 63091
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License 30-022164 (OH)
7845 CARNEGIE BLVD STE A, Fort Wayne, IN 46804
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Secondary Practice Locations 2

Location 11121 W Michigan StIndianapolis, IN 46202-5211 · Phone (317) 274-7433 · Fax (317) 274-2603
Location 2550 University Blvd Ste 3195Indianapolis, IN 46202-5149 · Phone (317) 274-7433 · Fax (317) 274-2603

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ryan M. Diepenbrock D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8022320563
PECOS Enrollment IDI20190501001946
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Ryan Diepenbrock's NPI number?

The NPI number for Ryan Diepenbrock is 1942399159. It was assigned to this individual provider in the NPPES registry on October 12, 2006.

Where is Ryan Diepenbrock located?

Ryan Diepenbrock practices at 7845 Carnegie Blvd Ste A, Fort Wayne, IN 46804. The listed phone number is (260) 423-2340.

What is Ryan Diepenbrock's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Ryan Diepenbrock enrolled in Medicare?

Yes. Ryan Diepenbrock is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ryan Diepenbrock was last updated on November 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.