Provider Demographics
NPI:1447971379
Name:SOUTHWEST SLEEP SOLUTIONS LLC
Entity type:Organization
Organization Name:SOUTHWEST SLEEP SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:516-640-7401
Mailing Address - Street 1:2983 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3204
Mailing Address - Country:US
Mailing Address - Phone:516-640-7401
Mailing Address - Fax:855-201-3647
Practice Address - Street 1:3618 W ANTHEM WAY STE D132
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-0475
Practice Address - Country:US
Practice Address - Phone:855-244-7533
Practice Address - Fax:855-201-3647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223X2210XDental ProvidersDentistOrofacial PainGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD05117OtherLISCENCE TO PRACTICE
AZBF5180803OtherCDS