Individual provider Active NPI

Dennis Eduardo Bueso, RD

  • Nutritionist
  • Norfolk, VA
National Provider Identifier
1417722281
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
Practice address
6201 E Virginia Beach Blvd Ste 110
Norfolk, VA 23502-2807
Phone
(757) 624-0600
Fax
(757) 461-3246
NPI assigned
Nov 21, 2023
Last updated
Apr 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X NU Primary

Addresses

Primary practice location

6201 E Virginia Beach Blvd Ste 110
Norfolk, VA 23502-2807

Mailing address

1509 Heritage Ave
Virginia Beach, VA 23464-7973
Phone (757) 724-2767

Other practice location 1

1509 Heritage Ave
Virginia Beach, VA 23464-7973
Phone (757) 724-2767

Other practice location 2

4403 Running Brook Dr Apt 302
Virginia Beach, VA 23462-7621
Phone (757) 724-2767

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1417722281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 HERITAGE AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234647973",
            "telephone_number": "757-724-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 E VIRGINIA BEACH BLVD STE 110",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022807",
            "telephone_number": "757-624-0600",
            "fax_number": "757-461-3246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1509 Heritage Ave",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234647973",
            "country_code": "US",
            "telephone_number": "757-724-2767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4403 Running Brook Dr Apt 302",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234627621",
            "country_code": "US",
            "telephone_number": "757-724-2767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUESO",
        "first_name": "DENNIS",
        "middle_name": "EDUARDO",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-21",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.