Provider Demographics
NPI:1427241173
Name:LEANO, KATRINA ANDRADA (DDS)
Entity type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:ANDRADA
Last Name:LEANO
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 1:9090 RED OAK TRL
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-2210
Mailing Address - Country:US
Mailing Address - Phone:651-226-1029
Mailing Address - Fax:
Practice Address - Street 1:1150 COUNTY ROAD E E STE 220
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55110-5122
Practice Address - Country:US
Practice Address - Phone:651-389-1002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI61771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice