Individual provider Active NPI

Dina Ben-Nissan, MS, RDN

  • Registered Dietitian
  • Tarzana, CA
National Provider Identifier
1114468667
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86063099 Issued in CA
Practice address
18372 Clark St Ste 228
Tarzana, CA 91356-3555
Phone
(818) 384-2886
NPI assigned
Mar 16, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 10182272 OR
Registered Dietitian 133V00000X 86063099 CA Primary

Addresses

Primary practice location

18372 Clark St Ste 228
Tarzana, CA 91356-3555

Mailing address

18372 Clark St Ste 228
Tarzana, CA 91356-3555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
86063099CAMDRegistered Dietitian
10182272ORMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1114468667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18372 CLARK ST STE 228",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18372 CLARK ST STE 228",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563555",
            "telephone_number": "818-384-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEN-NISSAN",
        "first_name": "DINA",
        "name_prefix": "Miss",
        "credential": "MS, RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "10182272",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86063099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.