DR. KENDRA KAY BODA (NPI# 1558519058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558519058 |
| Entity Type | Individual |
| Full Name | DR. KENDRA KAY BODA |
| Credential | D.D.S.,M.S. |
| Practice Address |
3004 Golf Rd Ste 102 Eau Claire WI 54701-8794 |
| Practice Telephone | (715) 552-8165 |
| Practice Fax Number | 7155527931 |
| Mailing Telephone | 7155528165 |
| Mailing Fax Number | 7155527931 |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2018-01-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
6901-15 | WI | Dental Providers |
| N | 1223E0200X |
Dentist Specialization: Endodontics |
D11633 | MN | Dental Providers |
| Street Address |
3004 GOLF RD STE 102 |
| City | EAU CLAIRE |
| State | WI |
| Zip Code | 54701-8794 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285141481 | Chippewa Valley Endodontics LLC | Dentist | 3004 Golf Rd Ste 102, Eau Claire, WI 54701-8794 | 2018-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649887563 | Molly Amanda Haferman | Pharmacist | 3184 London Road, Eau Claire, WI 54701 | 2020-09-24 |
| 1194375915 | Moments Hospice of Eau Claire LLC | Hospice Care, Community Based | 2263 East Ridge Center, Eau Claire, WI 54701 | 2019-09-13 |
| 1043778228 | Rita Marie Acosta | Emergency Medical Technician, Basic | 509 University Dr, Mcphee Atr, Eau Claire, WI 54701 | 2019-03-07 |
| 1619450954 | Michael Brown | Case Manager/Care Coordinator | 102 S Barstow St, Eau Claire, WI 54701 | 2018-09-12 |
| 1417436569 | Valerie Jayne Both | Social Worker | 1000 Starr Avenue, Eau Claire, WI 54701 | 2018-08-09 |
| 1023519055 | Rachel Delanois | Specialist/Technologist | Kinesiology --mcphee Physical Education Center 208, 509 University Drive, Eau Claire, WI 54701 | 2018-02-25 |
| 1427564863 | Matayla Springstroh | Specialist/Technologist | 509 University Drive, Eau Claire, WI 54701 | 2017-12-21 |
| 1265981062 | Molly Hart | Student in an Organized Health Care Education/Training Program | 509 University Dr., Eau Claire, WI 54701 | 2016-09-22 |
| 1982051918 | Renee Teigen-stary | Registered Nurse | 3440 Oakwood Hills Parkway, Eau Claire, WI 54701 | 2016-05-19 |
| 1699104059 | Susan Marie Keller | Speech-Language Pathologist | 3656 Mull Dr., Dove Healthcare - South, Eau Claire, WI 54701 | 2013-11-06 |
| Find all providers in zip 54701 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285141481 | Chippewa Valley Endodontics LLC | Dentist | 3004 Golf Rd Ste 102, Eau Claire, WI 54701-8794 | 2018-01-09 |
| 1659572642 | Megan Ann Bollman | Dentist | 1120 Oak Ridge Dr, Eau Claire, WI 54701-6133 | 2007-05-29 |
| 1801013297 | Keith Nmi Napolitano | Dentist | 3004 Golf Rd, Suite# 102, Eau Claire, WI 54701-8793 | 2007-04-19 |
| 1922164359 | Bruce Allen Begotka | Dentist | 431 E Clairemont Ave, Suite C, Eau Claire, WI 54701-3685 | 2006-12-29 |
| 1417029158 | Blair Johnson | Dentist | 1120 Oak Ridge Dr, Eau Claire, WI 54701-6133 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031464 | Central Wisconsin Endodontic Specialists LLC | Dentist | 2606 Stewart Avenue, #102, Wausau, WI 54401 | 2020-07-23 |
| 1891319273 | Janesville Endodontics | Dentist | 1616 N Randall Ave Ste 180, Janesville, WI 53545-1155 | 2020-06-02 |
| 1306480918 | Teng Kai Ong | Dentist | 1801 West Wisconsin Ave., Milwaukee, WI 53233 | 2019-11-06 |
| 1215344478 | Helen Tsao | Dentist | 2606 Stewart Ave, Ste 102, Wausau, WI 54401-5502 | 2014-07-18 |
| 1275973166 | Meridian Endodontics and Periodontics | Dentist | 20350 Water Tower Blvd Ste 203, Brookfield, WI 53045-3558 | 2013-06-25 |
| 1447698451 | Eva C Dahl | Dentist | 2700 National Dr Ste 1, Onalaska, WI 54650-6708 | 2013-06-12 |
| 1275873374 | F Kris Olsen | Dentist | 1320 S Green Bay Road, Racine Dental Group, Racine, WI 53406 | 2013-02-26 |
| 1063710655 | Erik Daniel Deyoung | Dentist | 6100 W State St, Apt. 636, Wauwatosa, WI 53213-2983 | 2011-03-05 |
| 1376786285 | Ronald David Meyers | Dentist | 2600 N Mayfair Rd Ste 240, Wauwatosa, WI 53226-1309 | 2009-04-08 |
| 1942450457 | Wisconsin Endodontic Group, S.c. | Dentist | 2600 N. Mayfair Rd., Ste 240, Wauwatosa, WI 53226 | 2008-09-22 |
| Find all providers with the same taxonomy | ||||
| City | EAU CLAIRE |
| Zip Code | 54701 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.