MEDICARE: DIETITIAN DISH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LD004769	OTHER	GA	LICENSED DIETITIAN
2	L008727	OTHER	NC	NORTH CAROLINA BOARD OF DIETETICS/NUTRITION

General Provider Information

NPI Number	:	1235726845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIETITIAN DISH

Provider Business Mailing Address
First Line	:	2692 GALAHAD DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-3627
Country	:	US
Telephone Number	:	704-351-1552
Fax Number	:

Provider Business Practice Location Address
First Line	:	2692 GALAHAD DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-3627
Country	:	US
Telephone Number	:	704-351-1552
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED DIETITIAN
Name	:	CHRISTINA ELLENBERG
Credential	:	MS, RD, LDN, CSCS
Telephone Number	:	704-351-1552

Provider Enumeration Date	:	12/29/2020
Last Update Date	:	07/24/2025

Similar Medicare Providers

1265970925 — CHRISTINA ELLENBERG RD, LDN, CSCS
Practice Location Address:

2692 GALAHAD DR NE
ATLANTA, GA
30345-3627

Practice Phone: 704-351-1552
Practice Fax:

1184728016 — GEORGIA CVS PHARMACY, L.L.C.
Practice Location Address:

3615 CLAIRMONT RD NE
ATLANTA, GA
30319-3627

Practice Phone: 404-320-6658
Practice Fax:

1922260819 — MS. ALEM DESTA TURPEAU MD
Practice Location Address:

1701 ADAMS DR SW
ATLANTA, GA
30311-3627

Practice Phone: 404-640-3023
Practice Fax:

1851066377 — SOOTHING SCALPS LLC
Practice Location Address:

901 BRIARVISTA WAY NE
ATLANTA, GA
30329-3627

Practice Phone: 404-392-1915
Practice Fax:

1720701725 — HUMAN TUNE-UP CLINIC, LLC.
Practice Location Address:

1701 ADAMS DR SW
ATLANTA, GA
30311-3627

Practice Phone: 404-640-3023
Practice Fax:

1780127894 — LAVANYA TORTIKER DMD
Practice Location Address:

2138 HENDERSON MILL RD NE
ATLANTA, GA
30345-3762

Practice Phone: 770-232-6272
Practice Fax:

Directions to “DIETITIAN DISH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.