Provider Demographics
NPI:1962013938
Name:OKLAHOMA SLEEP GROUP LLC
Entity Type:Organization
Organization Name:OKLAHOMA SLEEP GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARLEY-HARROD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-401-4639
Mailing Address - Street 1:2900 NW 156TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-2102
Mailing Address - Country:US
Mailing Address - Phone:405-401-4639
Mailing Address - Fax:405-471-5610
Practice Address - Street 1:2900 NW 156TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-2102
Practice Address - Country:US
Practice Address - Phone:405-401-4639
Practice Address - Fax:405-471-5610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies