Dr. Tyler Paul Bergien, DDS

Dentist, General Practice in Jackson, WY. Individual provider (NPI-1).

NPI number1669683025

StatusActive

Last updated in NPPESJul 8, 2007

Details

NPI: 1669683025
Entity type: Individual (NPI-1)
Name: Dr. Tyler Paul Bergien
Credential: DDS
Sex: Male
Sole proprietor: Yes
Enumeration date: May 25, 2007
Last updated: Jul 8, 2007

Medicare and OIG

Medicare enrolled (PECOS): Yes · ORDER AND REFERRING ONLY - DENTIST
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
1223G0001X	Dentist, General Practice	#1004	WY	Yes

Practice location

945 W Broadway
Suite #201
Jackson, WY 83001

Phone 307-734-5200 · Fax 307-733-2922

Mailing address

945 W Broadway
Suite 201,p O Box 11779
Jackson, WY 83001

Phone 307-734-5200 · Fax 307-733-2922

Is something wrong?

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Other General Practice Dentistry providers in Jackson, WY

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