Provider Demographics
NPI:1538892195
Name:DALE DIETITIANS LLC
Entity type:Organization
Organization Name:DALE DIETITIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN NUTRITIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLINGSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:702-493-9268
Mailing Address - Street 1:9056 E 50TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-3786
Mailing Address - Country:US
Mailing Address - Phone:702-493-9268
Mailing Address - Fax:
Practice Address - Street 1:8545 W WARM SPRINGS RD STE A-4159
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3676
Practice Address - Country:US
Practice Address - Phone:702-748-9311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-01
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty