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Export Provider Record NPI 1083011555
Jessica BoudaieDDS
Active
NPI Number1083011555
NPI TypeNPI-1 Individual
SpecialtyDentist
Provider Details
NPI1083011555
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2014-11-29
Last Updated2014-11-29
Mailing Address10933 Victory Blvd
North Hollywood, CA 91606-3717
United States
Phone: (818) 509-1818
📍 View Map
Primary Practice Address10933 Victory Blvd
North Hollywood, CA 91606-3717
United States
Phone: (818) 509-1818
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes122300000X – DentistCA64214
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About NPI 1083011555

Jessica Boudaie DDS is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1083011555. The primary specialty listed is Dentist. The provider is located in North Hollywood, CA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2014-11-29. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1083011555?

NPI 1083011555 belongs to Jessica Boudaie DDS, a Dentist in North Hollywood, CA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1083011555 active?

The current status of NPI 1083011555 in the NPPES registry is Active. The record was last updated on 2014-11-29.

What specialty is NPI 1083011555?

NPI 1083011555 is classified under the taxonomy Dentist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1083011555?

You can verify NPI 1083011555 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1083011555?

The primary practice address on file for NPI 1083011555 is 10933 Victory Blvd, North Hollywood, CA 91606-3717. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1083011555 issued?

NPI 1083011555 was first issued (enumerated) on 2014-11-29. The NPPES record was last updated on 2014-11-29.

Practice Location Map

Jessica Boudaie is located at 10933 Victory Blvd, North Hollywood, CA. Use the map below to find directions or verify the practice location.

📍 10933 Victory Blvd, North Hollywood, CA 91606-3717  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Jessica Boudaie. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1083011555. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Dentist64214CA
Data Verified from CMS NPPES Last synced: 2026-06-20 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162