Provider Demographics
NPI:1235610957
Name:DSM SLEEP SPECIALISTS
Entity Type:Organization
Organization Name:DSM SLEEP SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KONOPKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-224-3948
Mailing Address - Street 1:1275 NW 128TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-7403
Mailing Address - Country:US
Mailing Address - Phone:734-502-6716
Mailing Address - Fax:
Practice Address - Street 1:1275 NW 128TH ST STE 200
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7403
Practice Address - Country:US
Practice Address - Phone:515-224-3948
Practice Address - Fax:515-224-0469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty