Edwin L Bercier III – General Practice Dentistry

Key facts

NPI: 1598817249
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 2266 (LA)
Practice address: 300 N Polk St
Rayne, LA 70578-6551
Phone: (337) 334-3581
Fax: (337) 334-2812
NPI assigned: Jan 16, 2007
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

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.

Edwin L Bercier IV DDS Dentist · Rayne, LA · NPI 1689968695

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
2266	LA	MD	Mental Health Counselor

Practice roles

Organization	Specialty	Status	New patients
Edwin L Bercier IV DDS		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	2266	LA	Yes

Addresses

Primary practice location

300 N Polk St
Rayne, LA 70578-6551

Mailing address

PO Box 23
300 North Polk Street
Rayne, LA 70578-0023
Phone (337) 334-3581

Other identifiers

Identifier	Type	State	Issuer
1822663	Medicaid	LA

Other providers in Rayne, LA

All providers in Rayne, LA · General Practice Dentistry in Louisiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.