Provider Demographics
NPI:1043367212
Name:BENDER, EVA RENEE (DDS)
Entity type:Individual
Prefix:DR
First Name:EVA
Middle Name:RENEE
Last Name:BENDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 ETTIE ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-4016
Mailing Address - Country:US
Mailing Address - Phone:510-332-8968
Mailing Address - Fax:510-332-8968
Practice Address - Street 1:1624 FRANKLIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2897
Practice Address - Country:US
Practice Address - Phone:510-332-8968
Practice Address - Fax:510-332-8968
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA544531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice