# AEGIS DENTAL GROUP FORT WAYNE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Aegis Dental Group Fort Wayne
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992506513
- **Authorized official:** CYNTHIA NEUENSCHWANDER (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (574) 875-7711

## Contact information

- **Practice address:** 4975 W JEFFERSON BLVD, FORT WAYNE, IN 46804
- **Practice address phone:** (574) 875-7711
- **Mailing address:** 4975 W JEFFERSON BLVD, FORT WAYNE, IN 46804
- **Mailing address phone:** (574) 875-7711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 03/20/2025
- **Last updated:** 03/20/2025