Healthcare Provider Details

I. General information

NPI: 1386328953
Provider Name (Legal Business Name): LAYLA SHADIE FIJANY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24031 EL TORO RD STE 205
LAGUNA HILLS CA
92653-3152
US

IV. Provider business mailing address

5 AVIGNON
NEWPORT COAST CA
92657-1010
US

V. Phone/Fax

Practice location:
  • Phone: 949-338-2957
  • Fax:
Mailing address:
  • Phone: 949-338-2957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDDS106086
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: