Bergman Family Dental

Primary specialty

DentistTaxonomy code 122300000X

License

2005018472 Issued in MO

Legal business name

BERGMAN FAMILY DENTAL

Practice address

15421 Clayton Rd
Suite 302
Ballwin, MO 63011-3161

Phone

(636) 391-9666

NPI assigned

Dec 20, 2010

Last updated

Dec 20, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daniel E Bergman, D.D.S.

Title

Dentist

Phone

(636) 391-9666

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1292803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1619270337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15421 CLAYTON RD",
            "address_2": "SUITE 302",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113161",
            "telephone_number": "636-391-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15421 CLAYTON RD",
            "address_2": "SUITE 302",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113161",
            "telephone_number": "636-391-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGMAN FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-20",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "636-391-9666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2005018472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brigitte Ann Bell, RN
• Colleen Bellamy, RPH
• Benchmark Healthcare of Wildwood, LLC
• Kerry Hannon Bender, ED.D, SLP
• Lauren Bequette
• Daniel Edward Bergman, DDS
• Nicholas Berkenbile, DMD
• April Joan Berry
• Amanda Bertholomey
• Amber Alicia Bertoglio, PA-C

• Dentist in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; 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.