# MRS. MARISSA N. BENDER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1215988050
- **Gender:** F
- **Credential:** DMD, MBA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00009155 | WA | Yes |

## Other

- **Enumeration date:** 05/15/2006
- **Last updated:** 08/13/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01606946 | UNITED CONCORDIA PROVIDER | WA |
| 01 | — | 28641 | WASHINGTON DENTAL SERVICE | WA |
| 01 | — | 48726 | DHA PRACTICE ID | WA |
| 05 | — | 5046057 | — | WA |
| 01 | — | 51909 | DHA/FORTIS PROVIDER ID | WA |
| 01 | — | 5582BE | REGENCE BLUESHIELD | WA |