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Deactivated NPI 1003967605 Deactivated / Inactive NPI Male Practitioner

Dr. Emory Wallace Bryan , DDS

Dentist - General Practice • Fort Wayne, IN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Emory Bryan has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 12, 2007
NPI Deactivation Date October 05, 2020
Total Practice Duration ~13 Years of Practice (2007 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Emory Bryan, DDS was a registered Dentist - General Practice practicing in Fort Wayne, IN. Throughout an active medical career spanning 13 years, Dr. Bryan provided care at the practice location at 6427 GEORGETOWN NORTH BLVD until profile deactivation on 2020-10-05.

Practice Location & Contact Primary Location

Practice Address

6427 Georgetown North Blvd

Fort Wayne, IN 468157007

Telephone 2604859142
Fax 2604859783
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Fort Wayne, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 1.5 Yrs
State Avg: 14.3 Yrs
Regional Practice Density
148 Specialists

Practicing in Fort Wayne, IN (2204 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IN 12006287A

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Mary Ellen Argus , DDS

Dentist - General Practice

NPI 1164627857

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 05, 2020

Record deactivated on October 05, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 6427 GEORGETOWN NORTH BLVD, FORT WAYNE, IN 468157007 (Tel: 2604859142)

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Updated Business Mailing Address July 08, 2007

Registered at 6427 GEORGETOWN NORTH BLVD, FORT WAYNE, IN 468157007 (Tel: 2604859142)

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Provider Name / Credentials Updated July 08, 2007

Recorded as EMORY BRYAN, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #12006287A in IN)

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Initial NPI Registration & Enumeration January 12, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003967605
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 12, 2007
Last Update: July 08, 2007
Deactivation Date: October 05, 2020

Mailing Address

6427 Georgetown North Blvd

Fort Wayne, IN 468157007

Phone: 2604859142

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.