1700069051 NPI number — UCLA SCHOOL OF DENTISRTY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700069051 NPI number — UCLA SCHOOL OF DENTISRTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UCLA SCHOOL OF DENTISRTY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700069051
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10833 LE CONTE AVE.
Provider Second Line Business Mailing Address:
CHS 13-0600
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90095-1668
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-825-4705
Provider Business Mailing Address Fax Number:
310-206-5349

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10833 LE CONTE AVE
Provider Second Line Business Practice Location Address:
CHS 20-140
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-3075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-825-5161
Provider Business Practice Location Address Fax Number:
310-206-5349
Provider Enumeration Date:
12/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KAPILA
Authorized Official First Name:
SUNIL
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSOCIATE DEAN, PROFESSOR
Authorized Official Telephone Number:
310-825-4705

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  D51398 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: G0100502 . This is a "MEDI CAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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