Provider Demographics
NPI:1669360616
Name:BOGDANOVE, ARTHUR (RD,PHD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:BOGDANOVE
Suffix:
Gender:M
Credentials:RD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6013 W BROADWAY AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55428-2879
Mailing Address - Country:US
Mailing Address - Phone:651-756-9867
Mailing Address - Fax:
Practice Address - Street 1:6013 W BROADWAY AVE APT 104
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55428-2879
Practice Address - Country:US
Practice Address - Phone:651-756-9867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL694564133V00000X
133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management