Provider Demographics
NPI:1760904650
Name:ALEIGHIA B HELDERMAN, DMD, MS, PLLC
Entity Type:Organization
Organization Name:ALEIGHIA B HELDERMAN, DMD, MS, PLLC
Other - Org Name:KINGSPORT PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEIGHIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:HELDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS, PLLC
Authorized Official - Phone:502-649-5715
Mailing Address - Street 1:950 W 1ST NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-4550
Mailing Address - Country:US
Mailing Address - Phone:423-581-1877
Mailing Address - Fax:423-581-8961
Practice Address - Street 1:1741 MORELAND DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-2088
Practice Address - Country:US
Practice Address - Phone:423-247-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN94321223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty