Provider Demographics
NPI:1427527332
Name:DANIEL LEVI HAUGHT LLC
Entity type:Organization
Organization Name:DANIEL LEVI HAUGHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:TUINEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-750-6897
Mailing Address - Street 1:825 W BASELINE RD STE 6
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-5371
Mailing Address - Country:US
Mailing Address - Phone:480-777-5570
Mailing Address - Fax:
Practice Address - Street 1:825 W BASELINE RD STE 6
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-5371
Practice Address - Country:US
Practice Address - Phone:480-777-5570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-20
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty