Provider Demographics
NPI:1437480779
Name:LERNER, KRISTA N (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:N
Last Name:LERNER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1348 E BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4570
Mailing Address - Country:US
Mailing Address - Phone:612-325-3707
Mailing Address - Fax:
Practice Address - Street 1:1348 E BELMONT AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4570
Practice Address - Country:US
Practice Address - Phone:612-325-3707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND126571223G0001X, 1223S0112X
LAS6301223S0112X
WI1001166-151223S0112X
AZD0095191223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice