Healthcare Provider Details

I. General information

NPI: 1285256263
Provider Name (Legal Business Name): MY SLEEP SOLUTION, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8176 OLD DEXTER RD STE 106
CORDOVA TN
38016-0538
US

IV. Provider business mailing address

8176 OLD DEXTER RD STE 106
CORDOVA TN
38016-0538
US

V. Phone/Fax

Practice location:
  • Phone: 901-737-3606
  • Fax:
Mailing address:
  • Phone: 901-737-3606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
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. MARK AARON WHITLOCK
Title or Position: OWNER/ DENTIST
Credential: DDS
Phone: 901-737-3606