Provider Demographics
NPI:1972257103
Name:TRIVEDI, RIDDHI (RDN LDN)
Entity type:Individual
Prefix:
First Name:RIDDHI
Middle Name:
Last Name:TRIVEDI
Suffix:
Gender:F
Credentials:RDN LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8729 MANHATTAN AVE
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7748
Mailing Address - Country:US
Mailing Address - Phone:425-236-2846
Mailing Address - Fax:
Practice Address - Street 1:6136 FRISCO SQUARE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3251
Practice Address - Country:US
Practice Address - Phone:469-300-1392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61231011133V00000X
TXDT88164133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered