Active NPI
Joanna I Bodea, DMD
- Dentist
- Duluth, GA
National Provider Identifier
1861836553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN012688
- Practice address
- 5805 State Bridge Rd Ste L
Duluth, GA 30097-6427 - Phone
- (678) 474-4917
- Fax
- (678) 474-0244
- NPI assigned
- Apr 24, 2013
- Last updated
- Apr 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN012688 | GA | Primary |
Addresses
Primary practice location
5805 State Bridge Rd Ste L
Duluth, GA 30097-6427
Mailing address
5805 State Bridge Rd Ste L
Duluth, GA 30097-6427
Phone (678) 474-4917
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN012688 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366761600000",
"number": "1861836553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5805 STATE BRIDGE RD STE L",
"city": "DULUTH",
"state": "GA",
"postal_code": "300976427",
"telephone_number": "678-474-4917",
"fax_number": "678-474-0244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5805 STATE BRIDGE RD STE L",
"city": "DULUTH",
"state": "GA",
"postal_code": "300976427",
"telephone_number": "678-474-4917",
"fax_number": "678-474-0244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODEA",
"first_name": "JOANNA",
"middle_name": "I",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-24",
"last_updated": "2013-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN012688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.