Provider Demographics
NPI:1962054700
Name:BENDAS, JASON ANTHONY (DDS)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ANTHONY
Last Name:BENDAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 FELSITE ST
Mailing Address - Street 2:
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635-8835
Mailing Address - Country:US
Mailing Address - Phone:951-240-8082
Mailing Address - Fax:
Practice Address - Street 1:816 2ND ST
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-4124
Practice Address - Country:US
Practice Address - Phone:209-826-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1038161223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice