Provider Demographics
NPI:1265411011
Name:BENDER, JOSEPH M (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:BENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 E ROBINDALE RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1116
Mailing Address - Country:US
Mailing Address - Phone:702-456-2885
Mailing Address - Fax:702-436-4925
Practice Address - Street 1:121 E ROBINDALE RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1116
Practice Address - Country:US
Practice Address - Phone:702-456-2885
Practice Address - Fax:702-436-4925
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012498522085R0202X
NV42542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV200290201Medicaid
C95779Medicare UPIN
NV200290201Medicaid
NVAQ208VMedicare PIN