Provider Demographics
NPI:1922346717
Name:MONTANO, LEONA WILKIE (RDHAP)
Entity Type:Individual
Prefix:MRS
First Name:LEONA
Middle Name:WILKIE
Last Name:MONTANO
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27403 PINYON ST
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4385
Mailing Address - Country:US
Mailing Address - Phone:951-973-9833
Mailing Address - Fax:
Practice Address - Street 1:27403 PINYON ST
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4385
Practice Address - Country:US
Practice Address - Phone:951-973-9833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22990124Q00000X
CA459124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist