Emma Marie Meyer, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12013190A Issued in IN

Practice address

9901 Auburn Rd
Fort Wayne, IN 46825-2345

Phone

(260) 489-0001

NPI assigned

May 25, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Emma Lichtle Former name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ruckman Oral Surgery & Implant Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Wayne, IN
  • NPI 1093250151
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1326539362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 AUBURN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252345",
            "telephone_number": "260-489-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 AUBURN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252345",
            "telephone_number": "260-489-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "EMMA",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12013190A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "LICHTLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Benjamin Meyer
• Carrie Meyer
• Catherine Meyer
• Clifton Meyer
• Elizabeth Ann Meyer, PA-C
• Kari Meyer
• Leah Meyer, PT, DPT
• Marissa Meyer
• Michael E Meyer, NP
• Michelle Meyer

• Oral and Maxillofacial Surgery (Dentist) in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.