Dr. Brian Edward Bergeron
Endodontist
1430 John Wesley Gilbert Drive
Augusta
, Georgia 30912-0001
Dr. Brian Edward Bergeron
Endodontist
1430 John Wesley Gilbert Drive
Augusta
, Georgia 30912-0001
(706) 721-2151
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About
Features
Specialties
- Endodontist
Languages spoken
- English
Location
First Address
- Dr. Brian Edward Bergeron
- 1430 John Wesley Gilbert Drive
- Augusta, GA
- Zip : 30912-0001
- Phone : (706) 721-2151
Second Address
- Dr. Brian Edward Bergeron
- 1430 John Wesley Gilbert Drive
- Augusta, GA
- Zip : 30912-0001
- Phone : (706) 721-2151
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1223E0200X | Endodontist | 19662 | TX |
| Y | 1223E0200X | Endodontist | DN014614 | GA |
| N | 1223E0200X | Endodontist | DN12265 | FL |
National Provider Identifier
| NPI | 1063403079 |
|---|---|
| Provider Name | Dr. Brian Edward Bergeron |
| First Address | Augusta, GA 30912-0001 |
| Second Address | Augusta, GA 30912-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/10/2005 |
| Last Update Date | 22/10/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 003137074A | (05) | GA |
| ZX4614 | (05) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.