Dr Lora Wonderly, DMD in Fort Wayne, IN - Medicare Dentist Provider

Dr Lora Wonderly, DMD is a medicare enrolled "Dentist - General Practice" provider in Fort Wayne, Indiana. Her current practice location is 4616 W Jefferson Blvd, Fort Wayne, Indiana. You can reach out to her office (for appointments etc.) via phone at (260) 432-8596.

Dr Lora Wonderly is licensed to practice in Indiana (license number 12011879A) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1013207265.

Contact Information

	Dr Lora Wonderly, DMD
	4616 W Jefferson Blvd, Fort Wayne, IN 46804-6826
	(260) 432-8596
	Not Available

Healthcare Provider's Profile

Full Name	Dr Lora Wonderly
Gender	Female
Speciality	Dentist - General Practice
Location	4616 W Jefferson Blvd, Fort Wayne, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1013207265
Provider Enumeration Date: 04/08/2011
Last Update Date: 07/13/2016

Medicare PECOS Information:

PECOS PAC ID: 8820319643
Enrollment ID: I20170427000775

Medical Identifiers

Medical identifiers for Dr Lora Wonderly such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013207265	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	12011879A (Indiana)	Primary
1223G0001X	Dentist - General Practice	30.023620 (Ohio)	Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lora Wonderly is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Lora Wonderly, DMD 4616 W Jefferson Blvd, Fort Wayne, IN 46804-6826 Ph: (260) 432-8596	Dr Lora Wonderly, DMD 4616 W Jefferson Blvd, Fort Wayne, IN 46804-6826 Ph: (260) 432-8596

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Dentist in Fort Wayne, IN

Dr. Bryan David Braasch, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 6821 Woodcrest Dr, Fort Wayne, IN 46815 Phone: 260-417-4981
Dr. Bryan Mcguigan Thompson, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 5108 N Clinton St, Fort Wayne, IN 46825 Phone: 260-482-1551 Fax: 260-484-4537
James A Shupe Jr., DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 3030 Lake Ave, Suite 15, Fort Wayne, IN 46805 Phone: 260-422-8419 Fax: 260-422-3591
Dr. Roger Paul Valliere, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1330 E State Blvd, Fort Wayne, IN 46805 Phone: 260-484-5614
Dr. Allison Bergdoll, DDS, MS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2121 E Dupont Rd, Suite D, Fort Wayne, IN 46825 Phone: 260-490-3554
Matthew Gotsch, DDS Dentist Medicare: Medicare Enrolled Practice Location: 919 Florence Ave, Fort Wayne, IN 46808 Phone: 260-632-8486

Dr Lora Wonderly, DMD - Medicare Dentist in Fort Wayne, IN