DR. BRIAN EDWARD BERGERON DMD NPI 1063403079

NPI Information

NPI: 1063403079
Provider Name: DR. BRIAN EDWARD BERGERON, DMD
Classification: Dentist - 1223E0200X
Entity Type: Individual

Specialization: Endodontics

PECOS Registration: Yes

Address:
1430 JOHN WESLEY GILBERT DRIVE
AUGUSTA, GA
ZIP 30912
Phone: (706) 721-2151
Get Directions

DR. Brian Edward Bergeron, DMD is an endodontics dentist in Augusta, GA. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. DR. Brian Edward Bergeron, DMD NPI is 1063403079. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1430 JOHN WESLEY GILBERT DRIVE
AUGUSTA, GA
ZIP 30912-001
Phone: (706) 721-2151

The NPI 1063403079 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 10/31/2005 and was last updated on 10/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223E0200X	Dentist	Endodontics	19662	TEXAS	No
2	1223E0200X	Dentist	Endodontics	DN12265	FLORIDA	No
3	1223E0200X	Dentist	Endodontics	DN014614	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ZX4614	MEDICAID	SOUTH CAROLINA
2	003137074A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »