Individual
DR. JAMES TERRENCE O'NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7845 CARNEGIE BLVD, FORT WAYNE, IN 46804-5792
(260) 423-2340
(260) 969-4109
Mailing address
7845 CARNEGIE BLVD, FORT WAYNE, IN 46804-5792
(260) 423-2340
(260) 969-4118
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12010974A
IN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
12010974A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2010252480
—
IN
01
—
H192110
MEDICAREPTAN
OH
Enumeration date
05/29/2008
Last updated
01/15/2026
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