DR. RANDALL AUGUST BERGERON (NPI# 1275612376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275612376 |
| Entity Type | Individual |
| Full Name | DR. RANDALL AUGUST BERGERON |
| Credential | DDS |
| Practice Address |
7930 Wrenwood Blvd Ste B Baton Rouge LA 70809-7700 |
| Practice Telephone | 2259243635 |
| Practice Fax Number | 2259243736 |
| Mailing Telephone | 2259243635 |
| Mailing Fax Number | 2259243736 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2016-12-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
3809 | LA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1838098 | 05 |
| Street Address |
7930 WRENWOOD BLVD STE B |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70809-7700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619582640 | Lisha Kerr Jacobsen | Counselor | 7936 Wrenwood Drive, Bldg # A, Baton Rouge, LA 70809 | 2020-09-15 |
| 1790301596 | Louisiana Regenerative Medicine Center | Clinic/Center | 9456 Jefferson Hwy St A, Baton Rouge, LA 70809 | 2020-06-18 |
| 1093337305 | Sew Luxe Customs, LLC | Prosthetic/Orthotic Supplier | 8674 Quarters Lake Road, Building 11 Suit 1, Baton Rouge, LA 70809 | 2020-05-08 |
| 1366903908 | Tamika Wyna Piper | Counselor | 11445 Reiger Road, Baton Rouge, LA 70809 | 2019-03-27 |
| 1548734213 | Urg-hab Surgical Specialists | Pain Medicine | 8558 Jefferson Hwy, Baton Rouge, LA 70809 | 2019-01-16 |
| 1205306610 | Monique West | Case Manager/Care Coordinator | 9441 Common Street, Suite B, Baton Rouge, LA 70809 | 2018-11-28 |
| 1679061618 | Sara Elizabeth Nicole Altaean | Massage Therapist | Ability Massage & Day Spa, 7656 Jefferson Hwy Suite 1a, Baton Rouge, LA 70809 | 2018-04-25 |
| 1871098921 | Gary Bernard Jr. | Massage Therapist | 7656 Jefferson Hwy Suite 1a, Baton Rouge, LA 70809 | 2018-03-29 |
| 1619476355 | De'andria Banks | Behavior Technician | 9150 Bareford Drive, Baton Rouge, LA 70809 | 2018-02-08 |
| 1427561679 | Angiogenesis Medical LLC | Durable Medical Equipment & Medical Supplies | 8032 Summa Ave Ste D, Baton Rouge, LA 70809 | 2017-11-09 |
| Find all providers in zip 70809 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649898982 | Jeff Ellard Dds Apdc | Dentist | 541 Shadows Ln Ste B, Baton Rouge, LA 70806-6559 | 2020-07-13 |
| 1316364417 | Rebecca Day | Dentist | 4607 Sherwood Common Blvd Bldg 1, Baton Rouge, LA 70816-4892 | 2014-03-26 |
| 1346420866 | Associates In Pediatric Dentistry,llc | Dentist | 9000 Airline Hwy Ste 100, Baton Rouge, LA 70815-4183 | 2007-11-13 |
| 1023216546 | Kredenna Beverly | Dentist | 2314 Weymouth Dr., Ste. B, Baton Rouge, LA 70809-5207 | 2007-07-05 |
| 1932329380 | Paula Isabel Fonseca | Dentist | 8000 Gsri Ave, Baton Rouge, LA 70820 | 2007-04-26 |
| 1194888131 | Steven Edward Ripple | Dentist | 10522 S Glenstone Pl, Baton Rouge, LA 70810-2875 | 2006-12-19 |
| 1497818389 | Johnnie L Hunt | Dentist | 9804 Bluebonnet Blvd Ste A, Baton Rouge, LA 70810-6442 | 2006-12-19 |
| 1720198864 | Robert L Delarosa | Dentist | 4607 Sherwood Common Blvd, Ste 100, Baton Rouge, LA 70816-4295 | 2006-08-30 |
| 1255307393 | Ronald David Landry | Dentist | 2726 Continental Dr, Baton Rouge, LA 70808-3207 | 2006-02-28 |
| 1255336038 | Thurman C. Morgan Jr. | Dentist | 2314 Weymouth Dr, Ste A, Baton Rouge, LA 70809-1424 | 2005-06-17 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70809 |
Please comment or provide details below to improve the information on DR. RANDALL AUGUST BERGERON.
| 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.