Healthcare Provider Details

I. General information

NPI: 1548948144
Provider Name (Legal Business Name): OPTIMAL SLEEP OC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 OSBORN ST STE 140
IRVINE CA
92604-8656
US

IV. Provider business mailing address

2 OSBORN ST STE 140
IRVINE CA
92604-8656
US

V. Phone/Fax

Practice location:
  • Phone: 949-857-2004
  • Fax: 949-857-2079
Mailing address:
  • Phone: 949-857-2004
  • Fax: 949-857-2079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: THOMAS ALEXANDER
Title or Position: OWNER
Credential: DDS
Phone: 949-857-2004