Cassandra Elizabeth Worley Leding, DDS
Individual provider Active NPI Dentist · Old Hickory, TN
NPI 1184172124 · NPPES record last updated Jan 27, 2023
Key facts
- NPI
- 1184172124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4300 (AR)
- Practice address
- 1903 Old Hickory Blvd
Old Hickory, TN 37138-2856 - Phone
- (615) 847-3821
- Fax
- (615) 847-5544
- NPI assigned
- Sep 20, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171201001820 | TN | Order and Referring Only - Dentist |
6800153735 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4300 | AR | MD | Dentist |
| 10368 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chenal Valley Dental Center PLLC | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10368 | TN | |
| Dentist | 122300000X | 4300 | AR | Yes |
Addresses
Primary practice location
1903 Old Hickory Blvd
Old Hickory, TN 37138-2856
Mailing address
30 Rahling Circle
Little Rock, AR 72223
Phone (501) 821-3133
Other providers in Old Hickory, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.