Provider Demographics
NPI:1053707414
Name:BENDER, JODI (DO)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:BENDER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 S. CLEVELAND AVE
Mailing Address - Street 2:STE D
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8958
Mailing Address - Country:US
Mailing Address - Phone:614-865-7600
Mailing Address - Fax:614-392-2546
Practice Address - Street 1:550 S. CLEVELAND AVE
Practice Address - Street 2:STE D
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8958
Practice Address - Country:US
Practice Address - Phone:614-865-7600
Practice Address - Fax:614-392-2546
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34013823207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0361378Medicaid