Provider Demographics
NPI:1871453589
Name:SEDATION DENTAL OASIS LLC
Entity type:Organization
Organization Name:SEDATION DENTAL OASIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:FLORENTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-397-8760
Mailing Address - Street 1:10012 CALUMET AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-4055
Mailing Address - Country:US
Mailing Address - Phone:219-319-5159
Mailing Address - Fax:219-359-3005
Practice Address - Street 1:10012 CALUMET AVE STE B
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-4055
Practice Address - Country:US
Practice Address - Phone:219-319-5159
Practice Address - Fax:219-359-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-14
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty