Rona Bodman, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

64113 Issued in CA

Practice address

4305 University Ave
San Diego, CA 92105-1645

Phone

(619) 501-1235

NPI assigned

Jan 1, 2015

Sex

Female

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 AZ

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rona.bodman.1@32652.direct.athenahealth.com
• Direct secure messaging: rona.bodman.p1@direct.rrhc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marana Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Marana, AZ
  • NPI 1447263405

  Dentist

  Medicare reassignment NPD
• Marana Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1396512034
  NPD
• Marana Health Center, Inc

  • Clinic Pharmacy
  • Tucson, AZ
  • NPI 1073072450
  NPD (past)

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

{
    "created_epoch": "1420070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420070400000",
    "number": "1992193726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051645",
            "telephone_number": "619-501-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051645",
            "telephone_number": "619-501-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODMAN",
        "first_name": "RONA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-01",
        "last_updated": "2015-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Bodge
• Ashleigh Lauren Bodie
• Kim L Bodie, LCSW
• Lauri Ann Bodie, POSTPARTUM DOULA
• Amisha Vishal Bodiwala, RT,(R)(M)
• Marta Ivanna Bodnaruk, NURSE PRACTITIONER
• Richard Michael Bodor, M.D.
• Susan K Bodtke, M.D.
• Body Craft, Inc.
• Body-Mind Acuity, Inc.

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2015; 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.