Healthcare Provider Details

I. General information

NPI: 1568339489
Provider Name (Legal Business Name): SLEEP WELL MICHIGAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6452 MILLENNIUM STE 110
LANSING MI
48917-7881
US

IV. Provider business mailing address

2244 BURNING TREE CIR
OWOSSO MI
48867-1089
US

V. Phone/Fax

Practice location:
  • Phone: 989-413-0679
  • Fax:
Mailing address:
  • Phone: 989-413-0679
  • Fax:

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 Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KENNETH CHARLES ACKLEY II
Title or Position: OWNER
Credential: DDS
Phone: 989-413-0679