DR. RANDALL AUGUST BERGERON DDS NPI 1275612376

NPI Information

NPI: 1275612376
Provider Name: DR. RANDALL AUGUST BERGERON, DDS
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
7930 WRENWOOD BLVD
STE B
BATON ROUGE, LA
ZIP 70809
Phone: (225) 924-3635
Get Directions

DR. Randall August Bergeron, DDS is a pediatric dentistry dentist in Baton Rouge, LA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Randall August Bergeron, DDS NPI is 1275612376. 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:

7930 WRENWOOD BLVD
STE B
BATON ROUGE, LA
ZIP 70809-700
Phone: (225) 924-3635
Fax: (225) 924-3736

The enumeration date for this NPI number is 11/2/2006 and was last updated on 12/12/2016.

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	1223P0221X	Dentist	Pediatric Dentistry	3809	LOUISIANA	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	1838098	MEDICAID	LOUISIANA

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: 4/28/2024

NPI Synchronization or Removal

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