John Theodore Bercier, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4163 Issued in LA

Practice address

3212 Enterprise Blvd
Lake Charles, LA 70601

Phone

(337) 478-6690

Fax

(337) 477-7791

NPI assigned

Mar 19, 2007

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366567653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 ENTERPRISE BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70601",
            "telephone_number": "337-478-6690",
            "fax_number": "337-477-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 ENTERPRISE BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70601",
            "telephone_number": "337-478-6690",
            "fax_number": "337-477-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERCIER",
        "first_name": "JOHN",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "4163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841633",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mustafa Benrahla, PHARMACIST
• Latasha Benson-Lee
• Tanisha Benton
• Frances Bercier, D.D.S.
• John Bercier, DO
• Megan Bercier, LOTR
• Edward Carl Bergen, D.O.
• Brandy Lynn Bergeron
• Brennan Bergeron, APRN, PMHNP-BC
• Christine Carol Bergeron, APRN,NNP-BC

• General Practice Dentistry in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.