Provider Demographics
NPI:1356718407
Name:NORTHLAND SLEEP TECHNOLOGIES LLC
Entity type:Organization
Organization Name:NORTHLAND SLEEP TECHNOLOGIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HUKE
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-741-4611
Mailing Address - Street 1:6320 NW LAKECREST LN
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-3152
Mailing Address - Country:US
Mailing Address - Phone:816-741-4611
Mailing Address - Fax:816-741-5016
Practice Address - Street 1:6320 NW LAKECREST LN
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152-3152
Practice Address - Country:US
Practice Address - Phone:816-741-4611
Practice Address - Fax:816-741-5016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO15173122300000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty