Provider Demographics
NPI:1982237897
Name:CHAND, DIPIKA (RD, LD)
Entity Type:Individual
Prefix:
First Name:DIPIKA
Middle Name:
Last Name:CHAND
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3688 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-2634
Mailing Address - Country:US
Mailing Address - Phone:513-328-9169
Mailing Address - Fax:
Practice Address - Street 1:3219 CLIFTON AVE STE 225
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3043
Practice Address - Country:US
Practice Address - Phone:513-862-4957
Practice Address - Fax:513-862-4952
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH86113650133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0462231Medicaid