NPIMap

Organization Active NPI

Bender Medical Group, Inc

  • Dental Hygienist
  • Fort Collins, CO
National Provider Identifier
1033660931
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH002023867 Issued in CO
Legal business name
BENDER MEDICAL GROUP, INC
Practice address
313 W Drake Rd
Fort Collins, CO 80526
Phone
(970) 482-8881
Fax
(970) 482-9646
NPI assigned
Oct 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Authorized official

Name
Julie M Desaire
Title
Chief Business Development Officer
Phone
(970) 225-5107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X DH002023867 CO Primary

Addresses

Primary practice location

313 W Drake Rd
Fort Collins, CO 80526

Mailing address

4674 Snow Mesa Dr
Suite 140
Fort Collins, CO 80528-8615
Phone (970) 482-0213

Other names 1

  • Miramont Dental Hygiene Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bender Medical Group Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481760000000",
    "number": "1033660931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "SUITE 140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288615",
            "telephone_number": "970-482-0213",
            "fax_number": "970-482-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W DRAKE RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80526",
            "telephone_number": "970-482-8881",
            "fax_number": "970-482-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENDER MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-12-15",
        "status": "A",
        "authorized_official_last_name": "DESAIRE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF BUSINESS DEVELOPMENT OFFICER",
        "authorized_official_telephone_number": "970-225-5107"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "DH002023867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miramont Dental Hygiene",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.