MEDICARE: DR. CASSANDRA ELIZABETH WORLEY LEDING DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	10368	TN
2	122300000X	Dentist	4300	AR

General Provider Information

NPI Number	:	1184172124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CASSANDRA ELIZABETH WORLEY LEDING DDS

Provider Business Mailing Address
First Line	:	30 RAHLING CIRCLE
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72223
Country	:	US
Telephone Number	:	501-821-3133
Fax Number	:	501-222-9944

Provider Business Practice Location Address
First Line	:	1903 OLD HICKORY BLVD
Second Line	:
City	:	OLD HICKORY
State	:	TN
Zip	:	37138-2856
Country	:	US
Telephone Number	:	615-847-3821
Fax Number	:	615-847-5544

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2016
Last Update Date	:	01/27/2023

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