MEDICARE: SLEEP WELL MICHIGAN PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)
2	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1568339489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP WELL MICHIGAN PLLC

Provider Business Mailing Address
First Line	:	2244 BURNING TREE CIR
Second Line	:
City	:	OWOSSO
State	:	MI
Zip	:	48867-1089
Country	:	US
Telephone Number	:	989-413-0679
Fax Number	:

Provider Business Practice Location Address
First Line	:	6452 MILLENNIUM STE 110
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-7881
Country	:	US
Telephone Number	:	989-413-0679
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KENNETH CHARLES ACKLEY II
Credential	:	DDS
Telephone Number	:	989-413-0679

Provider Enumeration Date	:	10/23/2025
Last Update Date	:	06/08/2026

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