Healthcare Provider Details

I. General information

NPI: 1740882133
Provider Name (Legal Business Name): VAHI III, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2020
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 E WARNER RD STE 104
CHANDLER AZ
85225-0998
US

IV. Provider business mailing address

855 E WARNER RD STE 104
CHANDLER AZ
85225-0998
US

V. Phone/Fax

Practice location:
  • Phone: 480-786-1734
  • Fax: 480-899-5851
Mailing address:
  • Phone: 480-786-1734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN E TUINEI
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 602-750-6897