Provider Demographics
NPI:1417185737
Name:PLEASANT VIEW SLEEP DISORDERS CTR, LLC
Entity Type:Organization
Organization Name:PLEASANT VIEW SLEEP DISORDERS CTR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:CLARENCE
Authorized Official - Last Name:BENNERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-746-4533
Mailing Address - Street 1:254 REN MAR DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-3723
Mailing Address - Country:US
Mailing Address - Phone:615-746-4533
Mailing Address - Fax:615-746-4536
Practice Address - Street 1:254 REN MAR DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-3722
Practice Address - Country:US
Practice Address - Phone:615-746-4533
Practice Address - Fax:615-746-4536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-25
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS81901223S0112X
TNMD243042080S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep MedicineGroup - Multi-Specialty