Purdue University
NPI 1053512004ActiveOrganization· Dentist· Fort Wayne, IN
Dentist in Fort Wayne, Indiana, registered in NPPES in May 2007, part of Purdue University. The authorized official on file is Joan M. Vaughan, Director Hipaa Privacy Compliance.
Overview
| NPI | 1053512004 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Purdue University |
| NPI issued | May 29, 2007 |
| Last updated in NPPES | Aug 2, 2022 |
| Certified by provider | Aug 2, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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