Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1013207265 Individual Practitioner Female Practitioner

Dr. Lora Wonderly , DMD

Dentist - General Practice • Fort Wayne, IN

Professional Overview & Biography Verified Profile Summary

Dr. Lora Wonderly, DMD is a registered healthcare professional specializing in Dentist - General Practice in Fort Wayne, IN. Practice services are available at 4616 W JEFFERSON BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4616 W Jefferson Blvd

Fort Wayne, IN 468046826

Telephone 2604328596
Associated Practice Facility / Clinic
🏢 Midtown Dental P C Facility NPI 1417326083

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 12011879A

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License OH 30.023620

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. David Burns , DDS

Dentist - General Practice

NPI 1891702478

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 13, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location July 13, 2016

Registered at 4616 W JEFFERSON BLVD, FORT WAYNE, IN 468046826 (Tel: 2604328596)

📍
Updated Business Mailing Address July 13, 2016

Registered at 4616 W JEFFERSON BLVD, FORT WAYNE, IN 468046826 (Tel: 2604328596)

👤
Provider Name / Credentials Updated July 13, 2016

Recorded as LORA WONDERLY, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 13, 2016

Dentist (License #12011879A in IN)

🟢
Initial NPI Registration & Enumeration April 08, 2011

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: 1013207265
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 08, 2011
Last Update: July 13, 2016
Sole Proprietor: Yes

Mailing Address

4616 W Jefferson Blvd

Fort Wayne, IN 468046826

Phone: 2604328596

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.