| Agave Sleep And Wellness | |
|
4235 N 32nd Street Suite A Phoenix AZ 85082 | |
| (602) 957-3808 | |
| (602) 957-3830 |
| Full Name | Agave Sleep And Wellness |
|---|---|
| Speciality | Dentist |
| Location | 4235 N 32nd Street, Phoenix, Arizona |
| Authorized Official Name and Position | James Lanphere (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 6029144272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agave Sleep And Wellness Po Box 61025 Phoenix AZ 85082 Ph: (602) 957-3803 | Agave Sleep And Wellness 4235 N 32nd Street Suite A Phoenix AZ 85082 Ph: (602) 957-3808 |
| NPI Number | 1427440270 |
|---|---|
| Provider Enumeration Date | 03/02/2015 |
| Last Update Date | 05/18/2018 |
| Medicare PECOS PAC ID | 1759601818 |
|---|---|
| Medicare Enrollment ID | O20150513002369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427440270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Shari Aftahi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1235191867 PECOS PAC ID: 2264752203 Enrollment ID: I20150514002673 |
| Provider Name | Beth R Hamann |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1609875020 PECOS PAC ID: 2567782626 Enrollment ID: I20150520000146 |
| Provider Name | Elizaveta P Hamann |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1215310461 PECOS PAC ID: 1557681616 Enrollment ID: I20230621001426 |
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