Provider Demographics
NPI:1972161164
Name:LTD SLEEP DENTISTRY LLC
Entity type:Organization
Organization Name:LTD SLEEP DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-646-5595
Mailing Address - Street 1:8134 SAWYER BROWN RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-1447
Mailing Address - Country:US
Mailing Address - Phone:615-646-5595
Mailing Address - Fax:615-646-5399
Practice Address - Street 1:8134 SAWYER BROWN RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-1447
Practice Address - Country:US
Practice Address - Phone:615-646-5595
Practice Address - Fax:615-646-5399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1720100639OtherINDIVIDUAL NPI
TN1134561087OtherINDIVIDUAL NPI