Healthcare Provider Details

I. General information

NPI: 1588254080
Provider Name (Legal Business Name): DANIEL LEDEE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2021
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7473 W LAKE MEAD BLVD STE 100
LAS VEGAS NV
89128-0265
US

IV. Provider business mailing address

7473 W LAKE MEAD BLVD STE 100
LAS VEGAS NV
89128-0265
US

V. Phone/Fax

Practice location:
  • Phone: 702-787-1191
  • Fax:
Mailing address:
  • Phone: 702-787-1191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DANIEL LEDEE
Title or Position: OWNER
Credential: AU.D.
Phone: 702-787-1191