Active NPI
Matthew Dallas, RD
- Registered Dietitian
- Las Vegas, NV
National Provider Identifier
1306412499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 39944-DI-0
- Practice address
- 7656 W Sahara Ave Ste 110
Las Vegas, NV 89117-2773 - Phone
- (702) 467-0308
- NPI assigned
- May 31, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | 39944-DI-0 | NV | Primary |
Addresses
Primary practice location
7656 W Sahara Ave Ste 110
Las Vegas, NV 89117-2773
Mailing address
8108 Pecan Valley Ave
Las Vegas, NV 89131-4657
Phone (702) 467-0308
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39944-DI-0 | NV | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622419200000",
"number": "1306412499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8108 PECAN VALLEY AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891314657",
"telephone_number": "702-467-0308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7656 W SAHARA AVE STE 110",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891172773",
"telephone_number": "702-467-0308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALLAS",
"first_name": "MATTHEW",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-31",
"last_updated": "2021-05-31",
"certification_date": "2021-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NV",
"license": "39944-DI-0",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.