Lora Wonderly, DMD

General Practice Dentistry · Fort Wayne, IN

Individual Active NPI

NPI number 1013207265

Practice location

4616 W Jefferson Blvd
Fort Wayne, IN 46804-6826
Phone
(260) 432-8596

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NPI record

NPI
1013207265
Entity type
Individual (Type 1)
Enumeration date
April 8, 2011
Last updated
July 13, 2016
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 12011879A IN
General Practice Dentistry 1223G0001X 30.023620 OH

About Dr. Wonderly

Lora Wonderly, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 4616 W Jefferson Blvd, Fort Wayne, IN 46804-6826. The NPI number 1013207265 was assigned on April 8, 2011 and the record was last updated on July 13, 2016.

Dr. Wonderly lists 2 licenses in the registry: #12011879A (IN) for General Practice Dentistry; #30.023620 (OH) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Lora Wonderly, DMD?

The NPI number is 1013207265.

What is the phone number of Dr. Wonderly?

The phone number listed for the practice location is (260) 432-8596.

Where is Dr. Wonderly located?

4616 W Jefferson Blvd, Fort Wayne, IN 46804-6826.

What is the taxonomy code for Dr. Wonderly?

The primary taxonomy code is 1223G0001X – General Practice Dentistry; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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