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Contact Information

NICHOLAS J LEDDERHOF, BSCH, DDS, MSC, FRCD
1930 ALCOA HWY. MEDICAL BUILDING A, SUITE 335
KNOXVILLE, TN37920-1514
 Phone: 865-305-9022
 Fax: 865-305-9026
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for NICHOLAS J LEDDERHOF · (Male)

NPI # 1821586793
Status Active
Credentials BSCH, DDS, MSC, FRCD
Entity Individual
Enumeration date 04/26/2018
Last updated 11/21/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • ZZ License # 88428
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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