Provider Demographics
NPI:1689487274
Name:MITRY, DINA (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:MITRY
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11720 VALLEY FORGE WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-8288
Mailing Address - Country:US
Mailing Address - Phone:540-808-9175
Mailing Address - Fax:
Practice Address - Street 1:11720 VALLEY FORGE WAY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-8288
Practice Address - Country:US
Practice Address - Phone:540-808-9175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered