Healthcare Provider Details

I. General information

NPI: 1417616384
Provider Name (Legal Business Name): ALASKA SLEEP SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2021
Last Update Date: 12/08/2021
Certification Date: 12/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 DENALI ST STE 201
ANCHORAGE AK
99503-4001
US

IV. Provider business mailing address

2069 DUKE DR
ANCHORAGE AK
99508-4551
US

V. Phone/Fax

Practice location:
  • Phone: 615-278-6003
  • Fax: 907-563-6094
Mailing address:
  • Phone: 615-278-6003
  • Fax: 907-563-6094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JILL MOODY
Title or Position: SLEEP COORDINATOR
Credential: RDA
Phone: 615-278-6003