Breanna Nichole Bodtorf, RDH

Individual provider Active NPI Dental Hygienist · Yeagertown, PA

NPI 1366944290 · NPPES record last updated Apr 13, 2026

Key facts

NPI
1366944290
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
PHDH001234 (PA)
Practice address
21 Mann Avenue
Yeagertown, PA 17099
Phone
(717) 240-9697
NPI assigned
Mar 7, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DH073123PAMDDental Hygienist
PHDH001234PAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Network Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X PHDH001234 PA Yes
Dental Hygienist 124Q00000X DH073123 PA

Addresses

Primary practice location

21 Mann Avenue
Yeagertown, PA 17099

Mailing address

21 N Mann Ave
Yeagertown, PA 17099-9610

Other names

  • Breanna Nichole Cline Former name

Other providers in Yeagertown, PA

All providers in Yeagertown, PA · Dental Hygienist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.