Provider Demographics
NPI:1568256386
Name:NEMAT-BAKHSH, LAYLA (DDS)
Entity type:Individual
Prefix:DR
First Name:LAYLA
Middle Name:
Last Name:NEMAT-BAKHSH
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 1:4427 BIRDIE DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-0641
Mailing Address - Country:US
Mailing Address - Phone:949-842-6812
Mailing Address - Fax:
Practice Address - Street 1:5301 W SUNSET BLVD STE 4
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5694
Practice Address - Country:US
Practice Address - Phone:323-366-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111384122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist