Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1750146312 Deactivated / Inactive NPI Female Practitioner

Laura Bodnar

Dentist • Wildwood, FL

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Laura Bodnar has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 13, 2024
NPI Deactivation Date October 03, 2024
Total Practice Duration ~1 Years of Practice (2024 – 2024)

Professional Overview & Biography Verified Profile Summary

Laura Bodnar was a registered Dentist practicing in Wildwood, FL. Throughout an active medical career spanning 1 years, Laura Bodnar provided care at the practice location at 4675 E STATE ROAD 44 STE 104 until profile deactivation on 2024-10-03.

Practice Location & Contact Primary Location

Practice Address

4675 E State Road 44 Ste 104

Wildwood, FL 347857461

Telephone 3524183041
Associated Practice Facility / Clinic
🏢 Wildwood Dentists, Pa Facility NPI 1770940769

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Wildwood, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.2 Yrs
Regional Practice Density
9 Specialists

Practicing in Wildwood, FL (6414 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-02
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License FL DN31613

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Dr. Jordan Kennedy , DMD

Dentist - General Practice

NPI 1083788715

Doctor of Dental Medicine

Dr. Sivakumar Venkatachalam , DMD

Dentist - General Practice

NPI 1285202796

Doctor of Dental Medicine

NPI 1538901871

Doctor of Dental Surgery

Hsin-Yi Liu

Dentist - General Practice

NPI 1720651458
Sara Rifai

Dentist

NPI 1780246207

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location July 02, 2026

Registered at 4675 E STATE ROAD 44 STE 104, WILDWOOD, FL 347857461 (Tel: 3524183041)

📍
Updated Business Mailing Address July 02, 2026

Registered at 2218 CROWN VILLAGE RD APT 402, OCOEE, FL 347613748 (Tel: 7328777539)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 02, 2026

Dentist (License #DN31613 in FL)

🔄
NPI Profile Reactivated October 09, 2024

Record officially reactivated for active practice on October 09, 2024

📍
Updated Practice Location October 09, 2024

Registered at 3030 HARBOR BLVD STE G1, COSTA MESA, CA 926262562 (Tel: 7145466100)

📍
Updated Business Mailing Address October 09, 2024

Registered at 9377 MIRAMONTE, IRVINE, CA 926185615 (Tel: 7328777539)

⚠️
NPI Profile Deactivated October 03, 2024

Record deactivated on October 03, 2024

NPI Profile Active February 13, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location February 13, 2024

Registered at 225 FALLON RD # 235, STONEHAM, MA 021802904 (Tel: 7328777539)

📍
Updated Business Mailing Address February 13, 2024

Registered at 225 FALLON RD # 235, STONEHAM, MA 021802904 (Tel: 7328777539)

👤
Provider Name / Credentials Updated February 13, 2024

Recorded as LAURA BODNAR

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 13, 2024

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration February 13, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Laura Bodnar. Be the first to share your experience!

Sign in to leave a review for Laura Bodnar

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1750146312
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 13, 2024
Last Update: July 02, 2026
Deactivation Date: October 03, 2024
Sole Proprietor: Yes

Mailing Address

2218 Crown Village Rd Apt 402

Ocoee, FL 347613748

Phone: 7328777539

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.