MEDICARE: DORCAS JING TENG CHONG 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	86446782	AZ

General Provider Information

NPI Number	:	1578425419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORCAS JING TENG CHONG RDN

Provider Business Mailing Address
First Line	:	2228 N 52ND ST UNIT 143
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-3445
Country	:	US
Telephone Number	:	269-806-8076
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 N 12TH ST FL 2
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2837
Country	:	US
Telephone Number	:	602-521-5180
Fax Number	:

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

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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