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General NPI Number Information
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NPI Number | 1932098613
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Entity Type | Organization
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Legal Business Name | DENTAL SLEEP MEDICINE OF KENTUCKY, PSC
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 2811 BARDSTOWN RD
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City | LOUISVILLE
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State | KY
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Zip | 40205-2677
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Country | US
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Telephone | 502-308-4546
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Fax | 502-308-4243
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Provider Business Mailing Address
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Address Line | 2811 BARDSTOWN RD
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City | LOUISVILLE
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State | KY
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Zip | 40205-2677
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Country | US
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Telephone | 502-308-4546
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Fax | 502-308-4243
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER JOSEPH COSTELLO
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Credential | DMD
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Telephone | 502-308-4546
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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