Ryan Dean Zimmerman, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

12011459A Issued in IN

Practice address

4205 Hobson CT
Fort Wayne, IN 46815-8648

Phone

(260) 486-8778

Fax

(260) 486-7679

NPI assigned

Jun 18, 2010

Last updated

Feb 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

University of Kentucky College of Dentistry, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Fort Wayne Prosthodontics, Inc.

  • Prosthodontics
  • Fort Wayne, IN
  • NPI 1447713219
  Medicare reassignment

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1467773911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 HOBSON CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468158648",
            "telephone_number": "260-486-8778",
            "fax_number": "260-486-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 HOBSON CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468158648",
            "telephone_number": "260-486-8778",
            "fax_number": "260-486-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "RYAN",
        "middle_name": "DEAN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011459A",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IN",
            "license": "12011459A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Sue Zimmerman, M.S., CCC-A
• David M Zimmerman, M.D.
• Erin Zimmerman, NP
• Jennifer Lynn Zimmerman, RPH
• Jessica A. Zimmerman, M.ED, LMHC
• Courtney Zimpfer, RDN
• Victor Zindoga, FNP
• Gregory F Zink, O.D.
• Diane Lynn Zinn, OTR
• Jeffrey Zinn, RPH

• Prosthodontics in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Prosthodontics in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.