Healthcare Provider Details

I. General information

NPI: 1063356129
Provider Name (Legal Business Name): CRISTINA V RONCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 S LINWOOD AVE
BALTIMORE MD
21224-5090
US

IV. Provider business mailing address

1440 KENT RD
ESSEX MD
21221-6025
US

V. Phone/Fax

Practice location:
  • Phone: 410-921-0097
  • Fax:
Mailing address:
  • Phone: 443-826-2515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number1953
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: