Healthcare Provider Details

I. General information

NPI: 1609781814
Provider Name (Legal Business Name): HAAKU HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80B VETERANS BLVD.
ACOMA PUEBLO NM
87034
US

IV. Provider business mailing address

PO BOX 40
SAN FIDEL NM
87049-0040
US

V. Phone/Fax

Practice location:
  • Phone: 505-485-6461
  • Fax:
Mailing address:
  • Phone: 505-485-6461
  • 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: MS. JANAY MAUPIN
Title or Position: CEO
Credential: MBA
Phone: 505-485-6461