Provider Demographics
NPI:1639404148
Name:BENDER, JINNY (DMD)
Entity Type:Individual
Prefix:MRS
First Name:JINNY
Middle Name:
Last Name:BENDER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MRS
Other - First Name:JINNY
Other - Middle Name:
Other - Last Name:BANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1710 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-7702
Mailing Address - Country:US
Mailing Address - Phone:714-539-2374
Mailing Address - Fax:714-744-8984
Practice Address - Street 1:24012 AVENIDA DE LA CARLOTA
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-455-1400
Practice Address - Fax:714-744-8984
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42633122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist