Individual provider Active NPI

Janet C Bodey, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
National Provider Identifier
1568504538
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
054241 Issued in NY
Practice address
3915 Broadway
New York, NY 10032-1565
Phone
(212) 567-5536
Fax
(212) 202-6447
NPI assigned
Feb 13, 2007
Last updated
Jul 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 054241 NY Primary

Addresses

Primary practice location

3915 Broadway
New York, NY 10032-1565

Mailing address

3915 Broadway
New York, NY 10032-1565
Phone (212) 567-5536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090609000488 NY Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 8123119179
I20171221001964 CT Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 8123119179 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054241NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lanzi Burke and Associates LLC Oral and Maxillofacial Surgery PastSince Aug 16, 2021 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1568504538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321565",
            "telephone_number": "212-567-5536",
            "fax_number": "212-202-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321565",
            "telephone_number": "212-567-5536",
            "fax_number": "212-202-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODEY",
        "first_name": "JANET",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "054241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.