# JENNIFER WILLIAMS BERGSTROM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1386277507
- **Gender:** F
- **Credential:** DDS, MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D10925 | OR | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 600175115 | WI | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 8426620 | WI | — |

## Other

- **Enumeration date:** 02/17/2020
- **Last updated:** 08/03/2025