Healthcare Provider Details

I. General information

NPI: 1568822880
Provider Name (Legal Business Name): AZ SLEEP WELLNESS CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2016
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6920 E SHEA BLVD STE 201
SCOTTSDALE AZ
85254-7100
US

IV. Provider business mailing address

6920 E SHEA BLVD STE 201
SCOTTSDALE AZ
85254-7100
US

V. Phone/Fax

Practice location:
  • Phone: 480-699-1017
  • Fax: 480-634-5560
Mailing address:
  • Phone: 480-699-1017
  • Fax: 480-634-5560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ROGER BRIGGS
Title or Position: OWNER
Credential: DDS
Phone: 480-699-1017