Active NPI
Dominique Tucker, RDN
- Registered Dietitian
- Chandler, AZ
National Provider Identifier
1487446480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86418236
- Practice address
- 3100 W Ray Rd Ste 201
Chandler, AZ 85226-2472 - Phone
- (623) 399-6825
- Fax
- (623) 505-3474
- NPI assigned
- May 19, 2025
- 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 | 86418236 | AZ | Primary |
Addresses
Primary practice location
3100 W Ray Rd Ste 201
Chandler, AZ 85226-2472
Mailing address
18001 N 79TH Ave Ste A12
Glendale, AZ 85308-8398
Phone (623) 399-6825
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
18001 N 79TH Ave
Suite A12
Glendale, AZ 85308-8398
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86418236 | AZ | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Am Nutrition Services | Dietitian, Registered | Current | Accepting new patients |
Locations
3100 W Ray Rd
Ste 201
Chandler, AZ 85226
Phone (269) 312-1446
18001 N 79th Ave
Ste A12
Glendale, AZ 85308
Phone (623) 321-5380
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": "1747612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770768000000",
"number": "1487446480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18001 N 79TH AVE STE A12",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853088398",
"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": "3100 W RAY RD STE 201",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852262472",
"telephone_number": "623-399-6825",
"fax_number": "623-505-3474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "DOMINIQUE",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-19",
"last_updated": "2026-02-11",
"certification_date": "2026-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AZ",
"license": "86418236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.