Kathleen Ann Bergman

Primary specialty

DentistTaxonomy code 122300000X

License

1001246-15 Issued in WI

Practice address

730 Swede Ave
Turtle Lake, WI 54889

Phone

(715) 986-2599

NPI assigned

Jul 2, 2015

Last updated

Aug 24, 2026By the provider in NPPES

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

Enrolled in MN

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

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.

• The Lakes Community Health Center, Inc

  dba Northlakes Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Turtle Lake, WI
  • NPI 1033569124
  NPD (past)
• The Lakes Community Health Center, Inc

  dba NorthLakes Community Clinic

  • Federally Qualified Health Center (FQHC)
  • White Lake, WI
  • NPI 1679983423
  NPD (past)

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1407239833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 215TH ST N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550259114",
            "telephone_number": "651-341-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 SWEDE AVE",
            "city": "TURTLE LAKE",
            "state": "WI",
            "postal_code": "54889",
            "telephone_number": "715-986-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGMAN",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001246-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amery Regional Medical Center, Inc. (Turtle Lake Clinic)
• Brenda L Baribeau, LPC
• Benjamin John Brenna, P.T.
• Sheri R Brunette
• Cesa #11 Rural Health Dental Clinic
• Cumberland Memorial Hospital Inc (Cumberland Healthcare Turtle Lake Clinic)
• Cumberland Memorial Hospital, Inc

• Dentist in Turtle Lake, WI
• Providers in Turtle Lake, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.