Provider Demographics
NPI:1609485358
Name:MOZHI, DIMPLE ANEKA (RS, MS)
Entity Type:Individual
Prefix:MISS
First Name:DIMPLE
Middle Name:ANEKA
Last Name:MOZHI
Suffix:
Gender:F
Credentials:RS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6436 COLUMBIA PIKE
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2063
Mailing Address - Country:US
Mailing Address - Phone:202-431-6676
Mailing Address - Fax:
Practice Address - Street 1:1012 14TH ST NW STE 700
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3477
Practice Address - Country:US
Practice Address - Phone:202-431-6676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA86096564133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
86096564OtherCOMMISSION ON DIETETIC REGISTRATION