Ryan M. Diepenbrock, D.D.S.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

12012587A Issued in IN

Practice address

7845 Carnegie Blvd Ste a
Fort Wayne, IN 46804-5792

Phone

(260) 423-2340

NPI assigned

Oct 12, 2006

Last updated

Nov 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

Ohio State University College of Dentistry, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Oral and Maxillofacial Surgery Associates PCGroup PAC ID 1557430766, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oral & Maxillofacial Surgery Associates PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Wayne, IN
  • NPI 1831264324
  Medicare reassignment Care Compare group NPD
• Indiana University

  dba Indiana University School of Dentistry

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1689790552

  Oral and Maxillofacial Surgery

  Medicare reassignment NPD

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1942399159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7845 CARNEGIE BLVD STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045792",
            "telephone_number": "260-423-2340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 University Blvd Ste 3195",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025149",
            "country_code": "US",
            "telephone_number": "317-274-7433",
            "fax_number": "317-274-2603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1121 W Michigan St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025211",
            "country_code": "US",
            "telephone_number": "317-274-7433",
            "fax_number": "317-274-2603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEPENBROCK",
        "first_name": "RYAN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30-022164",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "63091",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IN",
            "license": "12012587A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill M Diedring, NP
• David M Diehl, DDS
• Melody Diehm
• Seagan Kay Diehm
• Kathryn Rudolph Diekhoff, NP
• Karla Kay Dierlam
• Miranda Diers
• Jody Diane Dietsch, LCSW
• Anne Marie Dietz, RDN
• Julea B. Diffenderfer, RD, CDE

• Oral & Maxillofacial Surgery (D.M.D.) in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.