Individual provider Active NPI

Dhaara Antani, RDN, MPH

  • Registered Dietitian
  • Detroit, MI
National Provider Identifier
1902422751
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86119679 Issued in MI
Practice address
5555 Conner St
Detroit, MI 48213-3448
Phone
(313) 344-4100
NPI assigned
Jun 17, 2020
Sex
Female
Sole proprietor
No

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

State licenses

LicenseStateTypeSpecialty
86119679MIMDRegistered Dietitian

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86119679 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

5555 Conner St
Detroit, MI 48213-3448

Mailing address

1468 Prestbury CT
Canton, MI 48187-2977
Phone (734) 945-3036

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
86119679OtherMICOMMISSION ON DIETETIC REGISTRATION (CDR)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 17, 2020.

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1902422751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 PRESTBURY CT",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872977",
            "telephone_number": "734-945-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 CONNER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133448",
            "telephone_number": "313-344-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTANI",
        "first_name": "DHAARA",
        "credential": "RDN, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MI",
            "license": "86119679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION (CDR)",
            "identifier": "86119679",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.