Healthcare Provider Details

I. General information

NPI: 1154278182
Provider Name (Legal Business Name): DAWHAWK TELEMAMMOGRAPHY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 INSPIRATIONAL DR
SEDONA AZ
86336-5611
US

IV. Provider business mailing address

PO BOX 4537
SEDONA AZ
86340-4537
US

V. Phone/Fax

Practice location:
  • Phone: 928-275-2588
  • Fax: 877-410-6639
Mailing address:
  • Phone:
  • Fax: 877-410-6639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHILALI VIAN
Title or Position: MEMBER
Credential:
Phone: 612-345-0415