Provider Demographics
NPI:1487192779
Name:SD DIAGNOSTICS INC
Entity Type:Organization
Organization Name:SD DIAGNOSTICS INC
Other - Org Name:BETTERNIGHT MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:TRACY
Authorized Official - Last Name:SALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:866-801-9440
Mailing Address - Street 1:5471 KEARNY VILLA RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1105
Mailing Address - Country:US
Mailing Address - Phone:619-299-6299
Mailing Address - Fax:619-299-6222
Practice Address - Street 1:311 NORTH ST STE 200
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2217
Practice Address - Country:US
Practice Address - Phone:866-801-9440
Practice Address - Fax:619-299-6222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic