IndividualActive
Nathan Dederman, OD, FAAO
NPI 1174005243 · Optometrist · Fort Leonard Wood, MO
Provider details
- NPI number
- 1174005243
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- OD, FAAO
- Sex
- Male
- Sole proprietor
- No
- License
- 3451 (TN)
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4430 Missouri Ave # 1267
Fort Leonard Wood, MO 65473-9098
Phone: (505) 249-9251
Approximate (ZIP-level) locationGet directions
Mailing address
4430 Missouri Ave # 1267
Fort Leonard Wood, MO 65473-9098
Registry dates
- Enumerated
- 2018-09-05
- Last updated
- 2024-01-12
- Certified
- 2023-08-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.