Healthcare Provider Details

I. General information

NPI: 1497392245
Provider Name (Legal Business Name): THE SLEEP DENTISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2019
Last Update Date: 11/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 HULL ST STE S
RICHMOND VA
23224-4069
US

IV. Provider business mailing address

921 HULL ST STE S
RICHMOND VA
23224-4069
US

V. Phone/Fax

Practice location:
  • Phone: 804-956-9129
  • Fax:
Mailing address:
  • Phone: 804-956-9129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. ALAN DAVID WALKER
Title or Position: OWNER/CEO
Credential: DDS
Phone: 804-956-9129