Provider Demographics
NPI:1760442461
Name:BENDER, JOHN D (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:BENDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 E ORCHARD RD
Mailing Address - Street 2:SUITE 200N
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2520
Mailing Address - Country:US
Mailing Address - Phone:303-339-1499
Mailing Address - Fax:303-339-1498
Practice Address - Street 1:2115 S SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-4905
Practice Address - Country:US
Practice Address - Phone:303-339-1499
Practice Address - Fax:303-339-1498
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29349208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01293497Medicaid
COD71638Medicare UPIN
COJ1388Medicare ID - Type Unspecified