DR. SHELLEY DANIELLE WADE BERGANSKE D.M.D. NPI 1922490333

NPI Information

NPI: 1922490333
Provider Name: DR. SHELLEY DANIELLE WADE BERGANSKE, D.M.D.
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
1380 PEACHTREE INDUSTRIAL BLVD STE 150
SUWANEE, GA
ZIP 30024
Phone: (770) 614-8914
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DR. Shelley Danielle Wade Berganske, D.M.D. is a pediatric dentistry dentist in Suwanee, GA. 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. Shelley Danielle Wade Berganske, D.M.D. NPI is 1922490333. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1380 PEACHTREE INDUSTRIAL BLVD STE 150
SUWANEE, GA
ZIP 30024-795
Phone: (770) 614-8914
Fax: (770) 614-8917

The enumeration date for this NPI number is 2/21/2015 and was last updated on 7/21/2022.

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	DN014966	GEORGIA	Yes
2	390200000X	Student in an Organized Health Care Education/Training Program		DN014966	GEORGIA	No

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: 5/5/2024

NPI Synchronization or Removal

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