Provider Demographics
NPI:1902984917
Name:HAUN, DONALD DARREN (DDS)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:DARREN
Last Name:HAUN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:D.
Other - Middle Name:DARREN
Other - Last Name:HAUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:3507 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-5013
Mailing Address - Country:US
Mailing Address - Phone:913-682-1000
Mailing Address - Fax:913-682-6131
Practice Address - Street 1:3507 S 4TH ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-5013
Practice Address - Country:US
Practice Address - Phone:913-682-1000
Practice Address - Fax:913-682-6131
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS63941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice