Provider Demographics
NPI:1396218368
Name:DENTON, JOAN DUSK (RDN)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:DUSK
Last Name:DENTON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 SAINT ANDREWS LN
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-6904
Mailing Address - Country:US
Mailing Address - Phone:817-559-9014
Mailing Address - Fax:
Practice Address - Street 1:116 SAINT ANDREWS LN
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-6904
Practice Address - Country:US
Practice Address - Phone:817-559-9014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84010133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered