Individual provider Active NPI

Leiza Yamila Walia, D.M.D.

  • Endodontics
  • Tustin, CA
National Provider Identifier
1144672270
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
101937 Issued in CA
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

Updated by the provider on Oct 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
101937CAMDEndodontist
059183NYMDPharmacist

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.

Verify at the official NPI Registry.