Healthcare Provider Details

I. General information

NPI: 1154771806
Provider Name (Legal Business Name): NICHOLAS STEVEN CAKMES D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 05/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 ALCOA HWY MEDICAL BUILDING A, SUITE 340
KNOXVILLE TN
37920-1500
US

IV. Provider business mailing address

222 N CENTRAL ST APT 207
KNOXVILLE TN
37917-7546
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10415
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: