Provider Demographics
NPI:1528193729
Name:HOFFMAN, DAWN A
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:A
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5430 W GLENN DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301
Mailing Address - Country:US
Mailing Address - Phone:623-915-0345
Mailing Address - Fax:623-937-5425
Practice Address - Street 1:5430 W GLENN DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-2628
Practice Address - Country:US
Practice Address - Phone:623-915-0345
Practice Address - Fax:623-937-5425
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0920174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist