Conrad Frank Bodai, DDS
Individual provider Active NPI Dentist · Fort Benning, GA
NPI 1699870964 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1699870964
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 26588 (CA)
- Practice address
- 7101 Hoff St
US Army Dental Activity
Fort Benning, GA 31905-5645 - Phone
- (706) 544-3954
- Fax
- (706) 544-1933
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250411001509 | NC | Practitioner - Dentist | 8426572421 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26588 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Carolina University | Current |
Accepting new patients | |
| East Carolina University | Current | Accepting new patients | |
| East Carolina University | Dentist | Current |
Accepting new patients |
Locations
1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 26588 | CA | Yes |
| General Practice Dentistry | 1223G0001X | 26588 | CA |
Addresses
Primary practice location
7101 Hoff St
US Army Dental Activity
Fort Benning, GA 31905-5645
Mailing address
7101 Hoff St
US Army Dental Activity
Fort Benning, GA 31905-5645
Phone (706) 544-3954
Other providers in Fort Benning, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.