MEDICARE: DR. LAYLA NEMAT-BAKHSH DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	111384	CA

General Provider Information

NPI Number	:	1568256386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAYLA NEMAT-BAKHSH DDS

Provider Business Mailing Address
First Line	:	4427 BIRDIE DR
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92883-0641
Country	:	US
Telephone Number	:	949-842-6812
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 W SUNSET BLVD STE 4
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5694
Country	:	US
Telephone Number	:	323-366-2900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2025
Last Update Date	:	04/07/2025

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