Lucy Tanya Hallajian, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DDS102436 Issued in CA

Practice address

10633 Etiwanda Ave
Porter Ranch, CA 91326-3114

Phone

(818) 389-6893

NPI assigned

Apr 14, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Children'S Hospital Los Angeles Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1265530653
  Medicare reassignment NPD
• Hallajian Dental Inc.

  • Pediatric Dentistry
  • Porter Ranch, CA
  • NPI 1588406516
  NPD Authorized official
• Lucy Hallajian DDS Inc

  • Pediatric Dentistry
  • Tarzana, CA
  • NPI 1386411361
  NPD Authorized official

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1770017956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10633 ETIWANDA AVE",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913263114",
            "telephone_number": "818-389-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10633 ETIWANDA AVE",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913263114",
            "telephone_number": "818-389-6893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 W Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276062",
            "country_code": "US",
            "telephone_number": "323-660-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALLAJIAN",
        "first_name": "LUCY",
        "middle_name": "TANYA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DDS102436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Guss, PHARM.D.
• Angela Guzman
• Josephine Hadiwidjojo, MS, RD, CDN
• Sarine Mary Hajjar, BCBA
• Hallajian Dental Inc.
• Catherine Junghye Han, O.D.
• Megan Joann Hanley, NP
• Hardeep Kataria OD Optometric Corporation
• Jessica Harland
• Hasan and Zorapapel DDS, Inc

• Pediatric Dentistry in Porter Ranch, CA
• Providers in Porter Ranch, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.