Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1063403079 Individual Practitioner Male Practitioner

Dr. Brian Edward Bergeron , DMD

Dentist - Endodontics • Augusta, GA

Professional Overview & Biography Verified Profile Summary

Dr. Brian Bergeron, DMD is a registered healthcare professional specializing in Dentist - Endodontics in Augusta, GA. Practice services are available at 1430 JOHN WESLEY GILBERT DRIVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1430 John Wesley Gilbert Drive

Augusta, GA 309120001

Telephone 7067212151
Associated Practice Facility / Clinic
🏢 Au Dental Associates Facility NPI 1457541781

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Endodontics in Augusta, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
16 Specialists

Practicing in Augusta, GA (162 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-02-19
Dentist - Endodontics Primary Specialty

NUCC Taxonomy Code: 1223E0200X

State License GA DN014614

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Dentist - Endodontics

NUCC Taxonomy Code: 1223E0200X

State License TX 19662

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Dentist - Endodontics

NUCC Taxonomy Code: 1223E0200X

State License FL DN12265

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
003137074A (GA)
Medicaid State Provider ID
ZX4614 (SC)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Dr. Frank Bishop , DMD

Dentist - Endodontics

NPI 1053399360

Doctor of Dental Medicine

NPI 1194988337

Doctor of Dental Medicine

NPI 1407439425

Doctor of Dental Medicine

NPI 1831762459

Doctor of Dental Medicine

NPI 1891742714

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 22, 2021

Dentist (License #19662 in TX)

👤
Provider Name / Credentials Updated March 22, 2021

Recorded as BRIAN BERGERON, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 22, 2021

Dentist (License #DN12265 in FL)

📍
Updated Practice Location February 24, 2021

Registered at 1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 309120001 (Tel: 7067212151)

📍
Updated Business Mailing Address February 24, 2021

Registered at 1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 309120001 (Tel: 7067212151)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 24, 2021

Dentist (License #DN014614 in GA)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 3 DS/SGD, 5955 ZEAMER AVENUE, ELMENDORF AFB, AK 99506 (Tel: 9075802973)

📍
Updated Business Mailing Address July 08, 2007

Registered at 3 DS/SGD, 5955 ZEAMER AVENUE, ELMENDORF AFB, AK 99506 (Tel: 9075802973)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as BRIAN BERGERON, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #19662 in TX)

🟢
Initial NPI Registration & Enumeration October 31, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1063403079
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 31, 2005
Last Update: February 19, 2026
Sole Proprietor: No

Mailing Address

1430 John Wesley Gilbert Drive

Augusta, GA 309120001

Phone: 7067212151

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.