Provider Demographics
NPI:1538599279
Name:DOSS, DORIAN (MS, RDN, LD, CPT)
Entity type:Individual
Prefix:MRS
First Name:DORIAN
Middle Name:
Last Name:DOSS
Suffix:
Gender:F
Credentials:MS, RDN, LD, CPT
Other - Prefix:MISS
Other - First Name:DORIAN
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RDN, LD, CPT
Mailing Address - Street 1:30 JOST VILLA DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-2270
Mailing Address - Country:US
Mailing Address - Phone:314-452-3273
Mailing Address - Fax:
Practice Address - Street 1:30 JOST VILLA DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-2270
Practice Address - Country:US
Practice Address - Phone:314-452-3273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005038119133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered