Individual provider Active NPI

Luiza Nersisyan, D.D.S.

  • General Practice Dentistry
  • Burbank, CA
National Provider Identifier
1407086952
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58348 Issued in CA
Practice address
2211 W Magnolia Blvd Ste 220
Burbank, CA 91506-1754
Phone
(818) 517-4047
NPI assigned
Jul 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 58348 CA Primary

Addresses

Primary practice location

2211 W Magnolia Blvd Ste 220
Burbank, CA 91506-1754

Mailing address

1832 N Bel Aire Dr
Burbank, CA 91504-1907
Phone (818) 517-4047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150814014246 CA Order and Referring Only - DentistPractitioner - Dentist 4587979851

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nersisyan DDS Inc CurrentSince Dec 24, 2023 Accepting new patients

Locations

2211 W Magnolia Blvd
Ste 220
Burbank, CA 91506
Phone (818) 517-4047

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1407086952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 N BEL AIRE DR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915041907",
            "telephone_number": "818-517-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 W MAGNOLIA BLVD STE 220",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915061754",
            "telephone_number": "818-517-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERSISYAN",
        "first_name": "LUIZA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.