Molly Bodendorfer, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

7768 Issued in NE

Practice address

2410 S 73Rd St
Omaha, NE 68124-2395

Phone

(402) 819-4977

NPI assigned

Apr 7, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1306200167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 N HALSTED ST APT 902",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611374",
            "telephone_number": "316-655-3731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 S 73RD ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242395",
            "telephone_number": "402-819-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENDORFER",
        "first_name": "MOLLY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021.003036",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NE",
            "license": "7768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kofi Messan Bockor
• Nickolas Alan Bockoven, PA-C
• Carylyn Bodammer, RN
• Tricia Bodammer, RN, BSN
• Ann M Bode, APRN
• Lauren L Bodhaine-Haywood, PHARMD
• Valerie J Bodlak-Harms, PAC
• Dawn M Bodnar, MD
• Trachelle Bodtke
• Body Boutique Lingerie LTD.

• Orthodontics and Dentofacial Orthopedics Dentistry in Omaha, NE
• Providers in Omaha, NE by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.