Provider Demographics
NPI:1265232441
Name:WEST, DAJON
Entity type:Individual
Prefix:
First Name:DAJON
Middle Name:
Last Name:WEST
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23720 DENTON ST APT 11
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-3477
Mailing Address - Country:US
Mailing Address - Phone:313-392-3726
Mailing Address - Fax:313-392-3726
Practice Address - Street 1:23720 DENTON ST APT 11
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-3477
Practice Address - Country:US
Practice Address - Phone:313-392-3726
Practice Address - Fax:313-392-3726
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory