Individual provider Active NPI

Leora H Sheily, DDS

  • General Practice Dentistry
  • Santa Monica, CA
National Provider Identifier
1700372802
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
102518 Issued in CA
Practice address
3231 Pico Blvd
Santa Monica, CA 90405-2113
Phone
(310) 828-7429
NPI assigned
Jul 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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 102518 CA Primary

Addresses

Primary practice location

3231 Pico Blvd
Santa Monica, CA 90405-2113

Mailing address

1975 Mandeville Canyon Rd
Los Angeles, CA 90049-2224
Phone (310) 709-6695

Other practice location 1

10933 Victory Blvd
North Hollywood, CA 91606-3717
Phone (818) 509-1818

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

Practice roles

OrganizationSpecialtyStatusNew patients
George Bochorishvili Dental Corp CurrentSince Jun 7, 2020 Accepting new patients
Leora H Sheily DDS PC General Practice CurrentSince Jun 7, 2020 Accepting new patients
Dr Daniel Boudaie DMD Inc Past Accepting new patients

Locations

4852 Melrose Ave
Los Angeles, CA 90029
Phone (323) 665-8168

3231 Pico Blvd
Santa Monica, CA 90405
Phone (310) 828-7429

Organizations & group practices 3

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1700372802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 MANDEVILLE CANYON RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900492224",
            "telephone_number": "310-709-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 PICO BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904052113",
            "telephone_number": "310-828-7429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10933 Victory Blvd",
            "address_purpose": "LOCATION",
            "city": "North Hollywood",
            "state": "CA",
            "postal_code": "916063717",
            "country_code": "US",
            "telephone_number": "818-509-1818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEILY",
        "first_name": "LEORA",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.