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Contact Information

RYAN M DIEPENBROCK, DDS
7845 CARNEGIE BLVD STE A
FORT WAYNE, IN46804-5792
 Phone: 260-423-2340
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for RYAN M DIEPENBROCK · (Male)

NPI # 1942399159
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 10/12/2006
Last updated 11/25/2025 - About 6 months ago
Sole proprietor 1 No
Identifiers
  • CA License # 63091
  • IN License # 12012587A
  • OH License # 30-022164
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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