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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: October 25, 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 1550 University Blvd Ste 3195Indianapolis, IN 46202-5149 · Phone (317) 274-7433 · Fax (317) 274-2603
Location 21121 W Michigan StIndianapolis, IN 46202-5211 · Phone (317) 274-7433 · Fax (317) 274-2603

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Ryan Diepenbrock reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Oral & Maxillofacial Surgery Associates PC
Same address
Oral and Maxillofacial Surgery
7845 CARNEGIE BLVD
Fort Wayne, IN 46804
  • Reassigned Medicare billing, Indiana enrollment
  • 6 clinicians in this Medicare group
NPI 1831264324 (260) 969-4105
Indiana University
101 mi
General Practice
1121 W MICHIGAN ST
Indianapolis, IN 46202
  • Reassigned Medicare billing, Indiana enrollment
  • 32 clinicians in this Medicare group
NPI 1689790552 (317) 274-7433

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Which organizations bill Medicare for Ryan Diepenbrock's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ryan Diepenbrock reassigns Medicare benefits to 2 organizations: Oral & Maxillofacial Surgery Associates PC (Fort Wayne, IN) and Indiana University (Indianapolis, IN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ryan Diepenbrock's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ryan Diepenbrock accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Delta Dental of Indiana list Ryan Diepenbrock as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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 11 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.