NPIMap

Organization Active NPI

TMJ & Sleep Therapy Centre of Fort Wayne, LLC

  • Dentist
  • Fort Wayne, IN
National Provider Identifier
1811531007
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
TMJ & SLEEP THERAPY CENTRE OF FORT WAYNE, LLC
Practice address
9121 Illinois Rd
Fort Wayne, IN 46804-5753
Phone
(260) 434-0099
Fax
(260) 434-0799
NPI assigned
Oct 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Authorized official

Name
Dr. Richard Presser, DDSNPI 1679607394
Title
President
Phone
(260) 434-0099

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

9121 Illinois Rd
Fort Wayne, IN 46804-5753

Mailing address

9121 Illinois Rd
Fort Wayne, IN 46804-5753
Phone (260) 434-0099

National Provider Directory

National Provider Directory

Locations

9121 Illinois Rd
Fort Wayne, IN 46804
Phone (260) 241-8454

Practitioners & affiliated clinicians

Practitioners 5

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": "1572480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576022400000",
    "number": "1811531007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9121 ILLINOIS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045753",
            "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": "9121 ILLINOIS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045753",
            "telephone_number": "260-434-0099",
            "fax_number": "260-434-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TMJ & SLEEP THERAPY CENTRE OF FORT WAYNE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A",
        "authorized_official_last_name": "PRESSER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-434-0099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "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 Dec 11, 2019; 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.