Healthcare Provider Details

I. General information

NPI: 1295286383
Provider Name (Legal Business Name): LUEKENGA WAY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MEDICAL DR 202A
BOUNTIFUL UT
84010-4946
US

IV. Provider business mailing address

415 MEDICAL DR STE A202
BOUNTIFUL UT
84010-4971
US

V. Phone/Fax

Practice location:
  • Phone: 801-298-4327
  • Fax: 801-298-4328
Mailing address:
  • Phone: 801-298-4327
  • Fax: 801-298-4328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number80296474101
License Number StateUT

VIII. Authorized Official

Name: JOSHUA C LUEKENGA
Title or Position: DOCTOR OF AUDIOLOGY/OWNER
Credential: AU.D
Phone: 801-298-4327