Healthcare Provider Details

I. General information

NPI: 1962754358
Provider Name (Legal Business Name): CRISTINA M LEON-PINEDA DMD, MPH, MSDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2012
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 AUBURN AVE STE 100
AUBURN WA
98002-5082
US

IV. Provider business mailing address

955 POWELL AVE SW
RENTON WA
98057-2908
US

V. Phone/Fax

Practice location:
  • Phone: 253-804-8713
  • Fax: 253-804-8755
Mailing address:
  • Phone: 425-277-1311
  • Fax: 425-277-1566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE60310679
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number34289
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDEN.00204868
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: