Healthcare Provider Details

I. General information

NPI: 1629728738
Provider Name (Legal Business Name): JACQUELYN BENDAVID ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 SAINT PAUL ST STE 324
BURLINGTON VT
05401-9826
US

IV. Provider business mailing address

305 SAINT PAUL ST STE 324
BURLINGTON VT
05401-9826
US

V. Phone/Fax

Practice location:
  • Phone: 802-881-0424
  • Fax:
Mailing address:
  • Phone: 802-881-0424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number099.0134170
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: