Dennis G Bergin, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

GA-1071-T Issued in GA

Practice address

400 Barrett Pkwy Ste 500
Sears Optical-Town Center Mall
Kennesaw, GA 30144-4997

Phone

(770) 424-5367

Fax

(678) 337-7933

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dennis Bergin Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• FL HMO C-SNP
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• FL HMO
• FL HMO D-SNP

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1003876921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 JULIA LYNN LANE",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301028184",
            "telephone_number": "770-424-5367",
            "fax_number": "678-337-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BARRETT PKWY STE 500",
            "address_2": "SEARS OPTICAL-TOWN CENTER MALL",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301444997",
            "telephone_number": "770-424-5367",
            "fax_number": "678-337-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGIN",
        "first_name": "DENNIS",
        "middle_name": "G",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "GA-1071-T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "843143605A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENNIS",
            "last_name": "BERGIN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shannon Worley Benefield, RN, IBCLC
• Stephen Corey Benjamin
• Kimberly Ann Bennett, L.P.C.
• Jennifer Anne Benson, PA C
• Rebecca Rae Bergert, LPC
• Avery Miller Berkhan, PHARMD, RPH
• Ericka Bermudez, BCABA
• Beti Homecare Services LLC
• Bettis Affinity
• Bridget Bettis

• Optometrist in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.