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

Midwest Oral and Maxillofacial Surgery P C

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1558416883

Midwest Oral and Maxillofacial Surgery P C is an Oral and Maxillofacial Surgery (Dentist) in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2007.

Licensed in
IN
In the registry since
2007

Practice location Address checks out

7230 Engle Rd Ste 301
Fort Wayne, IN 46804-2209
Phone: (260) 432-5566
Fax: (260) 432-5567
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 54000677 (IN)

Record details

NPI number1558416883
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Iczkovitz — President · (260) 484-9990
NPI enumeratedJanuary 25, 2007
Last updated in NPPESMarch 26, 2009
Mailing address3303 Trier Rd, Fort Wayne, IN 46815-4768

Other providers in Fort Wayne