Oral & Maxillofacial Surgery Associates PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC

Practice address

7845 Carnegie Blvd
Fort Wayne, IN 46804

Phone

(260) 969-4105

Fax

(260) 969-4118

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Celeste C Sholl

Title

Credentialing Coordinator

Phone

(260) 969-4113

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 9

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

• Ryan M. Diepenbrock, D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Fort Wayne, IN
  • NPI 1942399159

  Oral and Maxillofacial Surgery

  Medicare reassignment Care Compare group NPD
• Lucas S Reed, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Fort Wayne, IN
  • NPI 1033366711

  Oral and Maxillofacial Surgery

  Medicare reassignment Care Compare group NPD
• Steven R Schimmele, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Fort Wayne, IN
  • NPI 1538179684

  Oral and Maxillofacial Surgery

  Medicare reassignment Care Compare group NPD
• Josiah Michael Smith, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Wayne, IN
  • NPI 1700347168
  Medicare reassignment Care Compare group NPD
• Amy A Sutton, NP

  • Family Nurse Practitioner
  • Fort Wayne, IN
  • NPI 1912157173
  Medicare reassignment Care Compare group NPD
• James Terrence O'Neill, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Wayne, IN
  • NPI 1376701045
  Medicare reassignment Care Compare group
• David G Bojrab, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Wayne, IN
  • NPI 1487664512
  NPD (past)
• John E Buhler Jr, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Wayne, IN
  • NPI 1376553412
  NPD (past)
• Timothy J Shambaugh, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Wayne, IN
  • NPI 1124038260
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1831264324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7845 CARNEGIE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045792",
            "telephone_number": "260-969-4105",
            "fax_number": "260-969-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7845 CARNEGIE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46804",
            "telephone_number": "260-969-4105",
            "fax_number": "260-969-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "SHOLL",
        "authorized_official_first_name": "CELESTE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "260-969-4113"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200029030",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MAC",
            "identifier": "6185590001",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NGS DME MAC",
            "identifier": "6185590001",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ophthalmology Consultants of Fort Wayne, P.C.
• Ophthalmology Consultants of Fort Wayne, P.C.
• Danny Lee Opoien, R.PH.
• Francisca Opoku
• Opulent Home Care
• Orbital Diagnostic, LLC
• Dmytro Orel, MD
• Caleb Oren
• Origins Developmental LLC
• Orl PC

• 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 Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.