OrganizationActive
Indiana Pediatric Dental & Anesthesia LLC
NPI 1164016127 · Pediatric Dentistry · Fort Wayne, IN
Indiana Pediatric Dental & Anesthesia LLC is a Pediatric Dentistry organization in Fort Wayne, IN (NPI 1164016127).
Provider details
- NPI number
- 1164016127
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Lucian Boboia, Owner(512) 902-9997
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3030 Lake Ave Ste 15
Fort Wayne, IN 46805-5428
Phone: (512) 902-9997
Street-level locationGet directions
Mailing address
3030 Lake Ave Ste 15
Fort Wayne, IN 46805-5428
Registry dates
- Enumerated
- 2021-02-21
- Last updated
- 2021-02-21
- Certified
- 2021-02-21
Frequently asked questions
- What is Indiana Pediatric Dental & Anesthesia LLC's NPI number?
- Indiana Pediatric Dental & Anesthesia LLC's National Provider Identifier (NPI) is 1164016127, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Indiana Pediatric Dental & Anesthesia LLC?
- Indiana Pediatric Dental & Anesthesia LLC is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Indiana Pediatric Dental & Anesthesia LLC located?
- Indiana Pediatric Dental & Anesthesia LLC's practice location on file with NPPES is 3030 Lake Ave Ste 15, Fort Wayne, IN 46805-5428.
- What is Indiana Pediatric Dental & Anesthesia LLC's phone number?
- The practice phone number listed in the NPPES registry for Indiana Pediatric Dental & Anesthesia LLC is (512) 902-9997.
- Who is the authorized official for Indiana Pediatric Dental & Anesthesia LLC?
- The authorized official listed on Indiana Pediatric Dental & Anesthesia LLC's NPPES record is Lucian Boboia, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Indiana Pediatric Dental & Anesthesia LLC's NPI active?
- Yes — Indiana Pediatric Dental & Anesthesia LLC's NPI (1164016127) is active in the NPPES registry as of the last update on 2021-02-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.