Healthcare Provider Details

I. General information

NPI: 1689361578
Provider Name (Legal Business Name): ALEXANDRIA DAGGETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 E THOMAS RD
PHOENIX AZ
85016-7710
US

IV. Provider business mailing address

1919 E THOMAS RD
PHOENIX AZ
85016-7710
US

V. Phone/Fax

Practice location:
  • Phone: 602-933-0777
  • Fax:
Mailing address:
  • Phone: 602-933-0777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number79991
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: