Active NPI
Leiza Yamila Walia, D.M.D.
- Endodontics
- Tustin, CA
National Provider Identifier
1144672270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 101937
- Practice address
- 15160 Kensington Park Dr Ste 610
Tustin, CA 92782 - Phone
- (714) 294-0907
- NPI assigned
- Jul 13, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 059183 | NY | |
| Endodontics | 1223E0200X | 101937 | CA | Primary |
Addresses
Primary practice location
15160 Kensington Park Dr Ste 610
Tustin, CA 92782
Mailing address
427 Porter St Apt 1
Glendale, CA 91205-5077
Phone (818) 261-3563
Other practice location 1
506 6th St
Brooklyn, NY 11215-3609
Phone (818) 261-3563
Other practice location 2
427 Porter St Apt 1
Glendale, CA 91205-5077
Phone (818) 261-3563
Other practice location 3
15160 Kensington Park Dr Ste 610
Tustin, CA 92782
Phone (714) 294-0907
Other practice location 4
15160 Kensington Park Dr Ste 610
Tustin, CA 92782
Phone (714) 294-0907
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101937 | CA | MD | Endodontist |
| 059183 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570492800000",
"number": "1144672270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "427 PORTER ST APT 1",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912055077",
"telephone_number": "818-261-3563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15160 KENSINGTON PARK DR STE 610",
"city": "TUSTIN",
"state": "CA",
"postal_code": "92782",
"telephone_number": "714-294-0907"
}
],
"practiceLocations": [
{
"address_1": "506 6th St",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112153609",
"country_code": "US",
"telephone_number": "818-261-3563",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "427 Porter St Apt 1",
"address_purpose": "LOCATION",
"city": "Glendale",
"state": "CA",
"postal_code": "912055077",
"country_code": "US",
"telephone_number": "818-261-3563",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15160 Kensington Park Dr Ste 610",
"address_purpose": "LOCATION",
"city": "Tustin",
"state": "CA",
"postal_code": "92782",
"country_code": "US",
"telephone_number": "714-294-0907",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15160 Kensington Park Dr Ste 610",
"address_purpose": "LOCATION",
"city": "Tustin",
"state": "CA",
"postal_code": "92782",
"country_code": "US",
"telephone_number": "714-294-0907",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALIA",
"first_name": "LEIZA",
"middle_name": "YAMILA",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-13",
"last_updated": "2019-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "059183",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "101937",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.