Provider Demographics
NPI:1528319738
Name:TENENG, ASTRIDA AWA (MDA, RD, CDCES, LD,)
Entity type:Individual
Prefix:MRS
First Name:ASTRIDA
Middle Name:AWA
Last Name:TENENG
Suffix:
Gender:F
Credentials:MDA, RD, CDCES, LD,
Other - Prefix:
Other - First Name:ASTRIDA
Other - Middle Name:AWA
Other - Last Name:FENGWI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16567 SIOUX LN
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2048
Mailing Address - Country:US
Mailing Address - Phone:502-303-7705
Mailing Address - Fax:
Practice Address - Street 1:16567 SIOUX LN
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-2048
Practice Address - Country:US
Practice Address - Phone:240-780-8135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLD-0837133VN1004X, 133V00000X
133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic