Provider Demographics
NPI:1821707126
Name:GOOD NIGHT SLEEP & ORAL APPLIANCE OF VIRGINIA, PLC
Entity Type:Organization
Organization Name:GOOD NIGHT SLEEP & ORAL APPLIANCE OF VIRGINIA, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:LIPSCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-986-4058
Mailing Address - Street 1:2311 OAKENGATE LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-4051
Mailing Address - Country:US
Mailing Address - Phone:804-986-4058
Mailing Address - Fax:
Practice Address - Street 1:600 FOUNDERS BRIDGE BLVD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-6309
Practice Address - Country:US
Practice Address - Phone:804-986-4058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies