Provider Demographics
NPI:1114549516
Name:BERENS, DOROTHY MEGAN (RD)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:MEGAN
Last Name:BERENS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11547 W 102ND PL
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-6615
Mailing Address - Country:US
Mailing Address - Phone:303-775-2485
Mailing Address - Fax:
Practice Address - Street 1:11547 W 102ND PL
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-6615
Practice Address - Country:US
Practice Address - Phone:303-775-2082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered