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General NPI Number Information
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NPI Number | 1356289128
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Entity Type | Organization
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Legal Business Name | APEX DENTAL FORT WAYNE LLC
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 3601 HOBSON RD STE 101
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City | FORT WAYNE
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State | IN
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Zip | 46815-4537
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Country | US
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Telephone | 260-215-9155
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Fax | 260-215-9156
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Provider Business Mailing Address
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Address Line | 3601 HOBSON RD STE 101
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City | FORT WAYNE
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State | IN
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Zip | 46815-4537
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Country | US
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Telephone | 260-215-9155
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Fax | 260-215-9156
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | DR. SURESH KUMAR VARMA VEGESANA
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Credential | DDS
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Telephone | 270-243-0098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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