Organization · Type 2 NPI

Kethcart Sleep LLC

General Practice Dentistry · Phoenix, AZ

NPI number 1235641937 Active

Practice location

1277 E Missouri Ave Ste 102
Phoenix, AZ 85014-2916

Fax (602) 883-7252

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed
Durable Medical Equipment & Medical Supplies	332B00000X	D6695 (AZ)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

7 other providers at this address

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NPI record

NPI: 1235641937
Entity type: Organization (Type 2)
Issued: Nov 2, 2017
Last updated: Jul 13, 2020
Status: Active

Other names

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Central Phoenix Center for Tmj, Pain & Sleep Disorders · doing business as
Central Phoenix Center for Tmj, Pain & Sleep Disorders · doing business as

Authorized official

Dr. Stephanie Wagner Kethcart, DDS
Managaing Member/dentist
(602) 615-8516

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1235641937

Kethcart Sleep LLC's National Provider Identifier is 1235641937, issued on Nov 2, 2017. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Phoenix, AZ. The record was last updated on Jul 13, 2020.