Healthcare Provider Details

I. General information

NPI: 1558752386
Provider Name (Legal Business Name): BRAYDON FRANCIS HASKELL DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2015
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8415 N PIMA RD STE 250
SCOTTSDALE AZ
85258-4487
US

IV. Provider business mailing address

8415 N PIMA RD STE 250
SCOTTSDALE AZ
85258-4487
US

V. Phone/Fax

Practice location:
  • Phone: 480-948-7000
  • Fax:
Mailing address:
  • Phone: 480-948-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number9967
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: