=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508962275
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEONOR CRISTINA HERNANDEZ DE QUINONES D.D.S.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2006
-----------------------------------------------------
Last Update Date | 01/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 177 W EXCHANGE ST # SR
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44302-1706
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-543-0070
-----------------------------------------------------
Fax | 330-543-9060
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 PERKINS SQ
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44308-1063
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-543-0079
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number | 30021211
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------