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DR. NICHOLAS JOHN LEDDERHOF BSCH, DDS, MSC, FRCD
NPI 1821586793
Oral & Maxillofacial Surgery in Knoxville, TN

Active since April 26, 2018PECOS Enrolled
1930 ALCOA HWY. MEDICAL BUILDING A, SUITE 335, KNOXVILLE, TN 37920(865) 305-9022(865) 305-9026 Get Directions Write a Review

NPPES record last updated: November 21, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 21, 2018, Apr 26, 2018 (2 updates tracked since 2018).

About Dr. Nicholas John Ledderhof Bsch, Dds, Msc, Frcd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICHOLAS JOHN LEDDERHOF BSCH, DDS, MSC, FRCD (NPI 1821586793) is an individual oral & maxillofacial surgery provider in Knoxville, Tennessee, licensed in Foreign Country (88428) and active in the NPI registry since April 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821586793
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. NICHOLAS JOHN LEDDERHOFCredential: BSCH, DDS, MSC, FRCD
Location Address1930 ALCOA HWY. MEDICAL BUILDING A, SUITE 335Knoxville, TN 37920-1514
Mailing Address1930 Alcoa Hwy. Medical Building A, Suite 335Knoxville, TN 37920-1514 · (865) 305-9022 · Fax (865) 305-9026
Phone(865) 305-9022
Fax(865) 305-9026
Sole ProprietorNo
Enumeration DateApril 26, 2018
Last NPPES UpdateNovember 21, 20182 updates tracked since enumeration
✔ NPI 1821586793 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in ZZ · 88428
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1930 ALCOA HWY. MEDICAL BUILDING A, SUITE 335, Knoxville, TN 37920
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicholas John Ledderhof Bsch, Dds, Msc, Frcd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Ledderhof's NPI number?

The NPI number for Nicholas Ledderhof is 1821586793. It was assigned to this individual provider in the NPPES registry on April 26, 2018.

Where is Nicholas Ledderhof located?

Nicholas Ledderhof practices at 1930 Alcoa Hwy. Medical Building A, Suite 335, Knoxville, TN 37920. The listed phone number is (865) 305-9022.

What is Nicholas Ledderhof's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Nicholas Ledderhof enrolled in Medicare?

Yes. Nicholas Ledderhof is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicholas Ledderhof was last updated on November 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.