Kendra Kay Boda, D.D.S.,M.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

6901-15 Issued in WI

Practice address

3004 Golf Rd Ste 102
Eau Claire, WI 54701-8794

Phone

(715) 552-8165

Fax

(715) 552-7931

NPI assigned

Sep 9, 2008

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• Chippewa Valley Endodontics LLC

  • Endodontics
  • Eau Claire, WI
  • NPI 1285141481
  NPD (past) Authorized official

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1558519058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 GOLF RD STE 102",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547018794",
            "telephone_number": "715-552-8165",
            "fax_number": "715-552-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 GOLF RD STE 102",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547018794",
            "telephone_number": "715-552-8165",
            "fax_number": "715-552-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODA",
        "first_name": "KENDRA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D11633",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WI",
            "license": "6901-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Heron Wellness, LLC
• Mindy Blumenberg, LMT
• Kate Elizabeth Bobholz, AU.D.
• Scott Bobholz, M.D.
• Amanda L Bockenfeld, CRNA
• Sarah Bodeau, LPC, CSAC
• Kaitlyn Anne Bodette, APNP
• Body Focus
• Carey M Boehm, RN, APNP-CSC
• Ute Boehm, MT

• Endodontics in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Endodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.