Provider Demographics
NPI:1780190553
Name:HYPNOS, INC.
Entity Type:Organization
Organization Name:HYPNOS, INC.
Other - Org Name:KOALA CENTER FOR SLEEP DISORDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISSY
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:262-923-7879
Mailing Address - Street 1:405 N CALHOUN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-5902
Mailing Address - Country:US
Mailing Address - Phone:262-923-7879
Mailing Address - Fax:262-436-2541
Practice Address - Street 1:10610 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5013
Practice Address - Country:US
Practice Address - Phone:262-923-7879
Practice Address - Fax:262-436-2541
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HYPNOS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-15
Last Update Date:2020-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty