Individual provider Active NPI

Jiselle Nakoud, DDS

  • General Practice Dentistry
  • Granada Hills, CA
National Provider Identifier
1689596108
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
113592 Issued in CA
Practice address
11856 1/8 Balboa Blvd
Granada Hills, CA 91344-2759
Phone
(818) 366-0001
NPI assigned
Jul 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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 113592 CA Primary

Addresses

Primary practice location

11856 1/8 Balboa Blvd
Granada Hills, CA 91344-2759

Mailing address

12130 Bellando CT
Granada Hills, CA 91344-2103
Phone (818) 632-2695

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

NPI Registry JSON

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

{
    "created_epoch": "1785110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1689596108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12130 BELLANDO CT",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442103",
            "telephone_number": "818-632-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11856 1/8 BALBOA BLVD",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913442759",
            "telephone_number": "818-366-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKOUD",
        "first_name": "JISELLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-27",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "113592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.