Healthcare Provider Details

I. General information

NPI: 1255219903
Provider Name (Legal Business Name): SLEEP EASY DENTAL SPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 ANTIQUE ALY
YARDLEY PA
19067-5626
US

IV. Provider business mailing address

902 ANTIQUE ALY
YARDLEY PA
19067-5626
US

V. Phone/Fax

Practice location:
  • Phone: 509-760-2347
  • Fax:
Mailing address:
  • Phone: 267-394-6772
  • Fax: 267-394-6774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
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: DR. TALIA LAFOND
Title or Position: EMPLOYEE
Credential: DMD
Phone: 267-309-1449