Healthcare Provider Details

I. General information

NPI: 1528665981
Provider Name (Legal Business Name): DR. NAIRY SEKAYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5363 BALBOA BLVD STE 440
ENCINO CA
91316-2842
US

IV. Provider business mailing address

5363 BALBOA BLVD STE 440
ENCINO CA
91316-2842
US

V. Phone/Fax

Practice location:
  • Phone: 818-788-2155
  • Fax:
Mailing address:
  • Phone: 818-788-2155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS105106
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: