Provider Demographics
NPI:1508962275
Name:HERNANDEZ, LEONOR CRISTINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONOR
Middle Name:CRISTINA
Last Name:HERNANDEZ
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 1:3636 RIVER LN
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3819
Mailing Address - Country:US
Mailing Address - Phone:440-333-7447
Mailing Address - Fax:216-228-6630
Practice Address - Street 1:3591 RESERVE COMMONS DR STE 200
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5334
Practice Address - Country:US
Practice Address - Phone:330-723-7566
Practice Address - Fax:330-723-3054
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300212111223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2518912Medicaid