Robert Hall Bodendorf, D.M.D.
Individual provider Active NPI General Practice Dentistry · Orange, VA
NPI 1154479228 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154479228
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6638 (VA)
- Practice address
- 111 Spicers Mill Rd # a
Orange, VA 22960-1023 - Phone
- (540) 672-3661
- Fax
- (540) 672-1665
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6638 | VA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6638 | VA | Yes |
Addresses
Primary practice location
111 Spicers Mill Rd # a
Orange, VA 22960-1023
Mailing address
111 Spicers Mill Rd # a
Orange, VA 22960-1023
Phone (540) 672-3661
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All providers in Orange, VA · General Practice Dentistry in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.