Maria A Leon-Gandara, D.M.D.

Individual provider Active NPI General Practice Dentistry · Crownpoint, NM

NPI 1093932873 · NPPES record last updated Sep 2, 2026

Key facts

NPI
1093932873
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
1894 (PR)
Practice address
PO Box 358
Crownpoint, NM 87313-0358
Phone
(505) 786-5291
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1894PRMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1894 PR Yes

Addresses

Primary practice location

PO Box 358
Crownpoint, NM 87313-0358

Mailing address

PO Box 358
Crownpoint, NM 87313-0358
Phone (505) 786-5291

Other identifiers

IdentifierTypeStateIssuer
1894OtherPRDENTIST LICENSE

Other providers in Crownpoint, NM

All providers in Crownpoint, NM · General Practice Dentistry in New Mexico

Sources for this page

Verify at the official NPI Registry.