Provider Demographics
NPI:1790237600
Name:CENTRAL INDIANA SLEEP AND WELLNESS
Entity Type:Organization
Organization Name:CENTRAL INDIANA SLEEP AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:JON
Authorized Official - Last Name:BILYAK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:574-896-2543
Mailing Address - Street 1:106 W SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH JUDSON
Mailing Address - State:IN
Mailing Address - Zip Code:46366-1246
Mailing Address - Country:US
Mailing Address - Phone:574-896-2543
Mailing Address - Fax:574-896-2565
Practice Address - Street 1:106 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:NORTH JUDSON
Practice Address - State:IN
Practice Address - Zip Code:46366-1246
Practice Address - Country:US
Practice Address - Phone:574-896-2543
Practice Address - Fax:574-896-2565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010699A332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies