MEDICARE: EMILY DORKO RDN

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1386371136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY DORKO RDN

Provider Business Mailing Address
First Line	:	8098 MOUNT KATAKA ST
Second Line	:
City	:	ROXBOROUGH
State	:	CO
Zip	:	80125-9159
Country	:	US
Telephone Number	:	937-474-9270
Fax Number	:	855-615-2829

Provider Business Practice Location Address
First Line	:	3051 W 39TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-2023
Country	:	US
Telephone Number	:	937-474-9270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2022
Last Update Date	:	01/10/2024

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Directions to “ EMILY DORKO RDN” Practice Location

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