Individual provider Active NPI

Karin Laura Bodor, DMD

  • General Practice Dentistry
  • The Villages, FL
National Provider Identifier
1861675829
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 16669 Issued in FL
Practice address
8792 SE 165TH Mulberry LN
The Villages, FL 32162-5861
Phone
(352) 753-0784
NPI assigned
Dec 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 16669 FL Primary

Addresses

Primary practice location

8792 SE 165TH Mulberry LN
The Villages, FL 32162-5861

Mailing address

8792 SE 165TH Mulberry LN
The Villages, FL 32162-5861
Phone (352) 753-0784

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN 16669FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1861675829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8792 SE 165TH MULBERRY LN",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625861",
            "telephone_number": "352-753-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8792 SE 165TH MULBERRY LN",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625861",
            "telephone_number": "352-753-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODOR",
        "first_name": "KARIN",
        "middle_name": "LAURA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 16669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.