Jack Bendavid, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

22285 Issued in CA

Practice address

12444 Victory Blvd Ste 103
Valley Glen, CA 91606-3156

Phone

(818) 755-8588

Fax

(818) 755-8561

NPI assigned

Oct 23, 2006

Last updated

Apr 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Jacques Bendavid Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1991

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1891878872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 BLUEBELL AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916064414",
            "telephone_number": "818-755-8588",
            "fax_number": "818-755-8861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12444 VICTORY BLVD STE 103",
            "city": "VALLEY GLEN",
            "state": "CA",
            "postal_code": "916063156",
            "telephone_number": "818-755-8588",
            "fax_number": "818-755-8561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDAVID",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "22285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI#",
            "identifier": "1891878872",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "68-0603965",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT HEALTH/HUMAN SERVICES OI FILE #",
            "identifier": "H-98-40451-4",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUES",
            "last_name": "BENDAVID",
            "credential": "D.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rosa Adams
• Kellie Aponte
• Archwood House CLHF, Inc.
• Suzy Arevyan
• Arise and Shine Senior Care Residence
• Kelli Marie Castro, LCSW
• James R Dubensky
• Eleve' Care Inc.
• Karen Chicca Enyedy, PH.D.
• Rachel Joyce Dilla Felipe

• Chiropractor in Valley Glen, CA
• Providers in Valley Glen, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.