Provider Demographics
NPI:1386328953
Name:FIJANY, LAYLA SHADIE (DDS)
Entity type:Individual
Prefix:
First Name:LAYLA
Middle Name:SHADIE
Last Name:FIJANY
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 AVIGNON
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657-1010
Mailing Address - Country:US
Mailing Address - Phone:949-338-2957
Mailing Address - Fax:
Practice Address - Street 1:24031 EL TORO RD STE 205
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3152
Practice Address - Country:US
Practice Address - Phone:949-338-2957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-13
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1060861223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics