Provider Demographics
NPI:1407086952
Name:NERSISYAN, LUIZA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LUIZA
Middle Name:
Last Name:NERSISYAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 N BEL AIRE DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-1907
Mailing Address - Country:US
Mailing Address - Phone:818-517-4047
Mailing Address - Fax:
Practice Address - Street 1:2211 W MAGNOLIA BLVD STE 220
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1754
Practice Address - Country:US
Practice Address - Phone:818-517-4047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA583481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice