Lyla Boustani D.D.S. Dental Corporation

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

LYLA BOUSTANI D.D.S. DENTAL CORPORATION

Doing business as

Dental Specialty Center

Practice address

12626 Riverside Dr
Ste 403
Studio City, CA 91607-3420

Phone

(818) 980-0998

Fax

(818) 980-0991

NPI assigned

Mar 5, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Lyla Boustani, DDS

Title

President

Phone

(818) 980-0998

Specialties & licenses 3

Addresses

Other names 1

• Dental Specialty Center Doing business as

Locations

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393977600000",
    "number": "1538585294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12626 RIVERSIDE DR",
            "address_2": "STE 403",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916073420",
            "telephone_number": "818-980-0998",
            "fax_number": "818-980-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12626 RIVERSIDE DR",
            "address_2": "STE 403",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916073420",
            "telephone_number": "818-980-0998",
            "fax_number": "818-980-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYLA BOUSTANI D.D.S. DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-05",
        "last_updated": "2014-03-05",
        "status": "A",
        "authorized_official_last_name": "BOUSTANI",
        "authorized_official_first_name": "LYLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-980-0998",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Specialty Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• John Henry Macaray, RDO
• Ian Mackinnon
• Natalie M Maddison
• Elmera Maghar, CPE,LE
• Arl Justine Patulot Magundayao, PT, DPT

• Endodontics in Studio City, CA
• Providers in Studio City, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; 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.