Active NPI
Shireen D Dow, RD
- Registered Dietitian
- Glendale, AZ
National Provider Identifier
1174890040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1019300
- Practice address
- 17505 N 79TH Ave
Suite 110
Glendale, AZ 85308-8725 - Phone
- (623) 399-6825
- Fax
- (623) 505-3474
- NPI assigned
- Nov 21, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1019300 | WA | Primary |
Addresses
Primary practice location
17505 N 79TH Ave
Suite 110
Glendale, AZ 85308-8725
Mailing address
17505 N 79TH Ave
Suite 110
Glendale, AZ 85308-8725
Phone (623) 399-6825
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Am Nutrition Services | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321833600000",
"number": "1174890040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17505 N 79TH AVE",
"address_2": "SUITE 110",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853088725",
"telephone_number": "623-399-6825",
"fax_number": "623-505-3474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17505 N 79TH AVE",
"address_2": "SUITE 110",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853088725",
"telephone_number": "623-399-6825",
"fax_number": "623-505-3474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOW",
"first_name": "SHIREEN",
"middle_name": "D",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-21",
"last_updated": "2011-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WA",
"license": "1019300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.