Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Indiana Pediatric Dental & Anesthesia LLC

Organization Pediatric Dentistry · NPI 1164016127

Indiana Pediatric Dental & Anesthesia LLC is a Pediatric Dentistry in Fort Wayne, Indiana. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3030 Lake Ave Ste 15
Fort Wayne, IN 46805-5428
Phone: (512) 902-9997
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X

Record details

NPI number1164016127
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lucian Boboia — Owner · (512) 902-9997
NPI enumeratedFebruary 21, 2021
Last updated in NPPESFebruary 21, 2021
Certification dateFebruary 21, 2021
Mailing address3030 Lake Ave Ste 15, Fort Wayne, IN 46805-5428

Other providers in Fort Wayne