BRIDGEPORT RIVER DENTAL PC NPI 1346898293

NPI Information

  • NPI: 1346898293
  • Provider Name: BRIDGEPORT RIVER DENTAL PC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 1631 GORDON HWY STE 22
    AUGUSTA, GA
    ZIP 30906
  • Phone: (706) 790-9302

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NPI Details

BRIDGEPORT RIVER DENTAL PC is a general practice dentist in Augusta, GA. The provider is 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. BRIDGEPORT RIVER DENTAL PC NPI is 1346898293. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1631 GORDON HWY STE 22
AUGUSTA, GA
ZIP 30906-230
Phone: (706) 790-9302
Fax: (706) 739-4706

The provider's authorized official is Michelle Jacomino .
The authorized official title is Director Of Payor Relations and has the following contact phone number (770) 916-9000.

The enumeration date for this NPI number is 9/3/2019 and was last updated on 9/3/2019.

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
11223D0004XDentistDentist AnesthesiologistNo
21223E0200XDentistEndodonticsNo
31223P0221XDentistPediatric DentistryNo
41223P0300XDentistPeriodonticsNo
51223S0112XDentistOral and Maxillofacial SurgeryNo
61223G0001XDentistGeneral PracticeYes

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: 11/21/2025

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