=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033052790
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NICK SANDERS DDS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2026
-----------------------------------------------------
Last Update Date | 04/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4109 MOUNTAIN VIEW AVE STE 400
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37415-2096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-287-6150
-----------------------------------------------------
Fax | 423-287-6151
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 585 ALSTON DR
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37419-3104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-381-6823
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST/OWNER
-----------------------------------------------------
Name | DR. NICK SANDERS
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 318-381-6823
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------