Dennis Wilbert Bergman, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DD-1948 Issued in NM

Practice address

4041 Barbara Loop SE
Suite a
Rio Rancho, NM 87124-1065

Phone

(505) 891-1500

Fax

(505) 891-8400

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1356359772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13632 CANADA DEL OSO PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871118030",
            "telephone_number": "505-298-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 BARBARA LOOP SE",
            "address_2": "SUITE A",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241065",
            "telephone_number": "505-891-1500",
            "fax_number": "505-891-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "DENNIS",
        "middle_name": "WILBERT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD-1948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003299",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA DENTAL",
            "identifier": "1465519",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P7216",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "NM01810F",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Benitez
• Paige Rose Bennett, MA, LMHC, LADAC, NCC
• Ethan Michael Benning, MD
• Rhonda K Bentz, CNP
• Rebecca L Bercovitch, PTA
• Susanne Jane Bergstrom, D.O.M.
• Viktoria Lynn Berkheimer
• Jamie M Bermudez, OTR
• Laura Berndt, LCSW
• Audrey Bernius

• Dentist in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.