Provider Demographics
NPI:1457644130
Name:CASTLE PINES SLEEP SOLUTIONS LLC
Entity Type:Organization
Organization Name:CASTLE PINES SLEEP SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THIEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-688-5705
Mailing Address - Street 1:850 W HAPPY CANYON RD
Mailing Address - Street 2:STE B
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-3908
Mailing Address - Country:US
Mailing Address - Phone:303-688-5705
Mailing Address - Fax:
Practice Address - Street 1:850 W HAPPY CANYON RD
Practice Address - Street 2:STE B
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-3908
Practice Address - Country:US
Practice Address - Phone:303-688-5705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO6567480001Medicare NSC