Provider Demographics
NPI:1558506097
Name:KENNER, LEIGH CHRISTINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:CHRISTINE
Last Name:KENNER
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 1:17900 TALBOT RD S
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-8212
Mailing Address - Country:US
Mailing Address - Phone:425-271-1727
Mailing Address - Fax:
Practice Address - Street 1:17900 TALBOT RD S
Practice Address - Street 2:SUITE 103
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-8212
Practice Address - Country:US
Practice Address - Phone:425-271-1727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE600352631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice