Provider Demographics
NPI:1366033326
Name:SERENITY SLEEP SOLUTIONS CORP
Entity Type:Organization
Organization Name:SERENITY SLEEP SOLUTIONS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:F
Authorized Official - Last Name:MATA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MPH
Authorized Official - Phone:281-935-6072
Mailing Address - Street 1:5270 N O CONNOR BLVD APT 1207
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-5717
Mailing Address - Country:US
Mailing Address - Phone:281-935-6072
Mailing Address - Fax:
Practice Address - Street 1:4624 LAKEVIEW PKWY
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4027
Practice Address - Country:US
Practice Address - Phone:833-507-5337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty