Healthcare Provider Details

I. General information

NPI: 1477463784
Provider Name (Legal Business Name): BENDER MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 VIVIAN ST
GOLDEN CO
80401-4341
US

IV. Provider business mailing address

4674 SNOW MESA DR STE 140
FORT COLLINS CO
80528-8614
US

V. Phone/Fax

Practice location:
  • Phone: 970-225-5000
  • Fax:
Mailing address:
  • Phone: 970-225-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JULIE M DESAIRE
Title or Position: CBDO
Credential:
Phone: 970-225-5107