DR. ALLISON BERGDOLL (NPI# 1013234640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013234640 |
| Entity Type | Individual |
| Full Name | DR. ALLISON BERGDOLL |
| Credential | DDS, MS |
| Practice Address |
2121 E Dupont Rd Suite D Fort Wayne IN 46825-1546 |
| Practice Telephone | 2604903554 |
| Mailing Telephone | 2604903554 |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2010-04-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
12011061A | IN | Dental Providers |
| Street Address |
2121 E DUPONT RD SUITE D |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-1546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790787695 | Mulokozi K Lugakingira | Dentist | 2121 E Dupont Rd, C, Fort Wayne, IN 46825-1546 | 2005-08-11 |
| 1659891984 | George Robert Cooper Iv | Dentist | 2121 E Dupont Rd, Suite E, Fort Wayne, IN 46825 | 2017-06-27 |
| 1790003796 | Franklin Awah | Dentist | 2121 E Dupont Rd, Suite C, Fort Wayne, IN 46825-1546 | 2010-05-14 |
| 1265562235 | Philip C Roach | Dentist | 2121 E Dupont Rd, Suite B, Fort Wayne, IN 46825-1546 | 2007-03-07 |
| 1649347832 | Fort Wayne Oral Maxillofacial Surgery & Implant Center, LLC | Dentist | 2121 E Dupont Rd, Suite #c, Fort Wayne, IN 46825-1546 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326263948 | Summit Orthodontics, PC | Dentist | 2801 Maplecrest Rd, Fort Wayne, IN 46815-7015 | 2007-04-17 |
| 1114140134 | Jon D. Ingleman | Dentist | 223 E Tillman Rd, Fort Wayne, IN 46816-1016 | 2007-04-10 |
| 1891825543 | Angela Renee Becker | Dentist | 4638 W Jefferson Blvd, Fort Wayne, IN 46804-6886 | 2007-03-06 |
| 1659423606 | Steven J Hoagburg | Dentist | 5715 Maplecrest Rd, Fort Wayne, IN 46835-3838 | 2007-01-18 |
| 1255427480 | Timothy Jay Bussick Dds, Ms, Incorporated | Dentist | 7207 Engle Rd, Fort Wayne, IN 46804-2231 | 2006-10-05 |
| 1396858957 | Orthodontic Specialty Services, Inc. | Dentist | 1120 E Dupont Rd, Fort Wayne, IN 46825-1556 | 2006-08-17 |
| 1952313991 | Ronald Alan Cohen | Dentist | 10211 Dupont Circle Dr W Ste A, Fort Wayne, IN 46825-1625 | 2006-08-11 |
| 1780235374 | Kathryn Welch | Dentist | 223 E Tillman Rd, Fort Wayne, IN 46816-1079 | 2019-09-25 |
| 1588932644 | Brandon C. Parrish | Dentist | 223 E Tillman Rd, Fort Wayne, IN 46816-1079 | 2011-12-05 |
| 1518131200 | Timothy Jay Bussick | Dentist | 7207 Engle Rd, Fort Wayne, IN 46804-2231 | 2008-04-15 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
Please comment or provide details below to improve the information on DR. ALLISON BERGDOLL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.