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SAMANTHA YEVGENYEVNA BERGERON DDS
NPI 1639800808
Dentist in San Diego, CA

Active since June 20, 2022PECOS Enrolled
4142 ADAMS AVE STE 104, SAN DIEGO, CA 92116(619) 326-0157 Get Directions Write a Review

NPPES record last updated: November 21, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Samantha Yevgenyevna Bergeron Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA YEVGENYEVNA BERGERON DDS (NPI 1639800808) is an individual dentist in San Diego, California, licensed in California (109297) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639800808
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameSAMANTHA YEVGENYEVNA BERGERONCredential: DDS
Location Address4142 ADAMS AVE STE 104San Diego, CA 92116-2594
Mailing Address11212 Morning Creek Dr SSan Diego, CA 92128-4050 · (910) 232-8503
Phone(619) 326-0157
Sole ProprietorYes
Enumeration DateJune 20, 2022
Last NPPES UpdateNovember 21, 2023
NPPES CertifiedNovember 21, 2023
✔ NPI 1639800808 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 109297
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
4142 ADAMS AVE STE 104, San Diego, CA 92116
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Florida Combined Life and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Yevgenyevna Bergeron Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92116 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS SURA AL OBAIDY
Dentist (General Practice)
4142 ADAMS AVE STE 104
SAN DIEGO, CA 92116
San Diego County (619) 483-7977
EMILY WEN-HUI WU DMD
Dentist
4142 ADAMS AVE STE 104
SAN DIEGO, CA 92116
San Diego County (619) 326-0157

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Bergeron's NPI number?

The NPI number for Samantha Bergeron is 1639800808. It was assigned to this individual provider in the NPPES registry on June 20, 2022.

Where is Samantha Bergeron located?

Samantha Bergeron practices at 4142 Adams Ave Ste 104, San Diego, CA 92116. The listed phone number is (619) 326-0157.

What is Samantha Bergeron's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Samantha Bergeron enrolled in Medicare?

Yes. Samantha Bergeron is registered in the Medicare PECOS enrollment system.

What insurance does Samantha Bergeron accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Florida Combined Life, HRI Dental & Vision and Humana and 2 other insurers list Samantha Bergeron as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samantha Bergeron was last updated on November 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.