Dominique Ashley Russo, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

39929-DI-0 Issued in NV

Practice address

2850 W Horizon Ridge Pkwy Ste 200
Henderson, NV 89052-4395

Phone

(702) 485-7235

Fax

(833) 407-9212

NPI assigned

Aug 29, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1295455681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 JUNIPER CANYON CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891341836",
            "telephone_number": "702-279-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 W HORIZON RIDGE PKWY STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524395",
            "telephone_number": "702-485-7235",
            "fax_number": "833-407-9212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2850 W Horizon Ridge Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890524395",
            "country_code": "US",
            "telephone_number": "702-485-7235",
            "fax_number": "833-407-9212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 W Horizon Ridge Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890524395",
            "country_code": "US",
            "telephone_number": "702-485-7235",
            "fax_number": "833-407-9212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 W Horizon Ridge Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890524395",
            "country_code": "US",
            "telephone_number": "702-485-7235",
            "fax_number": "833-407-9212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 W Horizon Ridge Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890524395",
            "country_code": "US",
            "telephone_number": "702-485-7235",
            "fax_number": "833-407-9212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 W Horizon Ridge Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890524395",
            "country_code": "US",
            "telephone_number": "702-485-7235",
            "fax_number": "833-407-9212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "DOMINIQUE",
        "middle_name": "ASHLEY",
        "credential": "RDN, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NV",
            "license": "39929-DI-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dominique@desertdietitians.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Desert Dietitians LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2850 W Horizon Ridge Pkwy Ste 200",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890524395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael D Russell, PT,DPT, CSCS
• Roger Alan Russell, DC
• Sean Russell, OMD
• Sharon Alene Russell
• Troy D Russell, DC
• Kathryn Russo
• Stephaine Russo
• Adam Kelsey Russon, DO
• Randy Rutkin, MFT
• Ariane Ashimwe Ruyombyana

• Registered Dietitian in Henderson, NV
• Providers in Henderson, NV by specialty
• Registered Dietitian in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.