Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Integrated Skin Institute PLLC

Organization Dermatology Physician · NPI 1770351041

Integrated Skin Institute PLLC is a Dermatology Physician in Lebanon, Tennessee. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1424 W Baddour Pkwy Ste G
Lebanon, TN 37087-2685
Phone: (615) 314-1699
Fax: (615) 622-8905
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Procedural Dermatology Physician Taxonomy 207NS0135X
Plastic Surgery Physician Taxonomy 208200000X

Record details

NPI number1770351041
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tejaswi Mudigonda — Ceo · (551) 208-3090
NPI enumeratedDecember 18, 2023
Last updated in NPPESApril 7, 2024
Certification dateApril 7, 2024
Mailing address1424 W Baddour Pkwy Ste G, Lebanon, TN 37087-2685

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