NPIMap

Organization Active NPI

Summit Dental Group PC

  • General Practice Dentistry
  • Fort Wayne, IN
National Provider Identifier
1720175979
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12010594A Issued in IN
Legal business name
SUMMIT DENTAL GROUP PC
Practice address
7207 Engle Rd
Fort Wayne, IN 46804-2231
Phone
(260) 434-0099
Fax
(260) 434-0799
NPI assigned
Oct 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Rich Douglas Presser, DDS
Title
President/Dentist
Phone
(260) 434-0099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12010594A IN Primary

Addresses

Primary practice location

7207 Engle Rd
Fort Wayne, IN 46804-2231

Mailing address

7207 Engle Rd
Fort Wayne, IN 46804-2231
Phone (260) 434-0099

National Provider Directory

National Provider Directory

Locations

7207 Engle Rd
Fort Wayne, IN 46804
Phone (260) 434-0099

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720175979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7207 ENGLE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042231",
            "telephone_number": "260-434-0099",
            "fax_number": "260-434-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7207 ENGLE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042231",
            "telephone_number": "260-434-0099",
            "fax_number": "260-434-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRESSER",
        "authorized_official_first_name": "RICH",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "260-434-0099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010594A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.