Thomas M Bodnar, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

30020146 Issued in OH

Practice address

21851 Center Ridge Road #104
Rocky River, OH 44130

Phone

(440) 886-3829

Fax

(440) 356-7033

NPI assigned

Oct 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891880886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21851 CENTER RIDGE ROAD #104",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "44130",
            "telephone_number": "440-886-3829",
            "fax_number": "440-356-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21851 CENTER RIDGE ROAD #104",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "44130",
            "telephone_number": "440-886-3829",
            "fax_number": "440-356-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODNAR",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30020146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betty Blaha, LPN
• Summer Alia Blair, ANP-BC
• Bloom at Rocky River, LLC
• Kaitlyn Paige Bober
• Kenneth Jude Bodnar, DDS
• Karen Annie Bradley, MD
• Irina Bransteter, PHD
• Kyle Aaron Bray, DPM
• Breakthrough Addiction and Behavioral Health Services LLC
• Brent a. Basile, MSW, LLC

• Periodontics in Rocky River, OH
• Providers in Rocky River, OH by specialty
• Periodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.