Robert T Bergman, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D21237 Issued in CA

Practice address

400 Mobil Ave Ste C1
Camarillo, CA 93010-6377

Phone

(805) 482-7284

Fax

(805) 482-5196

NPI assigned

Sep 28, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Robert T. Bergman, DDS, Ms, Inc.

  • Dental Clinic/Center
  • Camarillo, CA
  • NPI 1205011293
  NPD (past) Authorized official

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1043407422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MOBIL AVE STE C1",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106377",
            "telephone_number": "805-482-7284",
            "fax_number": "805-482-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MOBIL AVE STE C1",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106377",
            "telephone_number": "805-482-7284",
            "fax_number": "805-482-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "ROBERT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-28",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "D21237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "B21237-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Bennett, PH.D.
• Tracy S Bennett, PH.D.
• Anya Berenshteyn, NP
• Roni Anne Valencia Bergantinos, PT
• Karl William Bergenstal, PH.D.
• Matthew Bermudez
• Marizza Berrington
• Nicole Best, PT
• Heather Bestwick
• Bethany Christian Services of Sounthern Ca

• Orthodontics and Dentofacial Orthopedics Dentistry in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.