Allison Bergdoll, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

12011061A Issued in IN

Practice address

2121 E Dupont Rd
Suite D
Fort Wayne, IN 46825-1546

Phone

(260) 490-3554

NPI assigned

Apr 21, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Indiana Orthodontics, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fort Wayne, IN
  • NPI 1982411088
  NPD Authorized official

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1013234640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E DUPONT RD",
            "address_2": "SUITE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251546",
            "telephone_number": "260-490-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E DUPONT RD",
            "address_2": "SUITE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251546",
            "telephone_number": "260-490-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGDOLL",
        "first_name": "ALLISON",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12011061A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Berdahl, MD
• Antonia Berelsman
• Grace Berg, MSW
• Jill C. Berg, NP-C
• Michael Richard Berg, CRNA
• Berger Dentistry SW
• Jonathan A Berger, MD
• Suzanne Lisette Berger
• Timothy Stephan Berger, D.M.D.
• Lisa A Bergeron, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; 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.