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General NPI Number Information
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NPI Number | 1205609245
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Entity Type | Organization
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Legal Business Name | SLEEP REMEDIES, LLC
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 304 S REGENT ST STE 101-18
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-5960
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Country | US
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Telephone | 928-275-1252
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Fax |
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Provider Business Mailing Address
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Address Line | 2756 W HIGHLAND MEADOWS DR
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City | WILLIAMS
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State | AZ
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Zip | 86046-9179
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Country | US
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Telephone | 920-918-0843
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MALLORY J NYENHUIS
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Credential | DDS
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Telephone | 920-918-0843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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