Active NPI
Laura M Bodner, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Manhasset, NY
National Provider Identifier
1174934632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 057260
- Practice address
- 306 Community Dr
Apt 3O
Manhasset, NY 11030-3838 - Phone
- (516) 972-0857
- NPI assigned
- May 17, 2014
- Last updated
- Nov 16, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 057260 | NY | Primary |
Addresses
Primary practice location
306 Community Dr
Apt 3O
Manhasset, NY 11030-3838
Mailing address
306 Community Dr
Apt 3O
Manhasset, NY 11030-3838
Phone (516) 972-0857
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057260 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416096000000",
"number": "1174934632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 COMMUNITY DR",
"address_2": "APT 3O",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110303838",
"telephone_number": "516-972-0857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 COMMUNITY DR",
"address_2": "APT 3O",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110303838",
"telephone_number": "516-972-0857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODNER",
"first_name": "LAURA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-17",
"last_updated": "2014-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NY",
"license": "057260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhasset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.