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General NPI Number Information
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NPI Number | 1902796402
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Entity Type | Individual
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Provider Name | KENIA GISELLE LEON DDS
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Gender | Female
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 3425 W THUNDERBIRD RD STE 13
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City | PHOENIX
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State | AZ
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Zip | 85053-5670
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Country | US
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Telephone | 480-916-7447
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Fax |
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Provider Business Mailing Address
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Address Line | 23350 N 23RD AVE UNIT 7036
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City | PHOENIX
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State | AZ
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Zip | 85027-0029
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Country | US
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Telephone | 928-920-7143
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D012584
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License Number State | AZ
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