Healthcare Provider Details

I. General information

NPI: 1780598359
Provider Name (Legal Business Name): SEVINCH DJALILOVA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 PICASSO AVE STE D
DAVIS CA
95618-0548
US

IV. Provider business mailing address

7012 STACCATO WAY
ROSEVILLE CA
95747-4351
US

V. Phone/Fax

Practice location:
  • Phone: 530-756-3340
  • Fax:
Mailing address:
  • Phone: 916-502-3182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number113886
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: