Provider Demographics
NPI:1780914689
Name:BERGMAN, ADAM VINCENT (DMD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:VINCENT
Last Name:BERGMAN
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11950 COUNTY ROAD 101
Mailing Address - Street 2:SUITE 204
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162
Mailing Address - Country:US
Mailing Address - Phone:352-391-5590
Mailing Address - Fax:
Practice Address - Street 1:11950 COUNTY ROAD 101
Practice Address - Street 2:SUITE 204
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162
Practice Address - Country:US
Practice Address - Phone:352-391-5590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN189001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics