Provider Demographics
NPI:1497175913
Name:GOOD SLEEP DENTAL THERAPY
Entity Type:Organization
Organization Name:GOOD SLEEP DENTAL THERAPY
Other - Org Name:SLEEP TESTING AND TREATMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RIAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYEK
Authorized Official - Suffix:
Authorized Official - Credentials:DS
Authorized Official - Phone:301-284-8833
Mailing Address - Street 1:23076 THREE NOTCH RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CALIFORNIA
Mailing Address - State:MD
Mailing Address - Zip Code:20619-2442
Mailing Address - Country:US
Mailing Address - Phone:301-284-8833
Mailing Address - Fax:240-526-1454
Practice Address - Street 1:23076 THREE NOTCH RD
Practice Address - Street 2:SUITE 302
Practice Address - City:CALIFORNIA
Practice Address - State:MD
Practice Address - Zip Code:20619-2442
Practice Address - Country:US
Practice Address - Phone:301-284-8833
Practice Address - Fax:240-526-1454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014103971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty