NPIMap

Organization Active NPI

UCLA Periodontal Clinic

  • Periodontics
  • Los Angeles, CA
National Provider Identifier
1376641720
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2059 Issued in CA
Legal business name
UCLA PERIODONTAL CLINIC
Practice address
UCLA School of Dentistry
CHS B0 130
Los Angeles, CA 90095-1668
Phone
(310) 825-3795
Fax
(310) 825-9653
NPI assigned
Sep 20, 2006
Last updated
May 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Flavia Pirih, DDS, PHDNPI 1669716437
Title
Chair
Phone
(310) 825-6486

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2059 CA Primary

Addresses

Primary practice location

UCLA School of Dentistry
CHS B0 130
Los Angeles, CA 90095-1668

Mailing address

10833 Le Conte Ave
CHS Bo 130
Los Angeles, CA 90095-1668
Phone (310) 825-3795

Other identifiers 2

IdentifierTypeStateIssuer
D34623OtherCADENTICAL
02059OtherCADELTA DENTAL OF CA GROUP

National Provider Directory

National Provider Directory
Tax ID family
Michael C Graves MD56 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

10833 Le Conte Ave
#130
Los Angeles, CA 90095
Phone (310) 825-3795

10833 Le Conte Ave
#63048
Los Angeles, CA 90095
Phone (310) 825-3795

Ucla School Of Dentistry
Los Angeles, CA 90095
Phone (310) 825-6510

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620604800000",
    "number": "1376641720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "CHS BO 130",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951668",
            "telephone_number": "310-825-3795",
            "fax_number": "310-825-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCLA SCHOOL OF DENTISTRY",
            "address_2": "CHS B0 130",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951668",
            "telephone_number": "310-825-3795",
            "fax_number": "310-825-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCLA PERIODONTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A",
        "authorized_official_last_name": "PIRIH",
        "authorized_official_first_name": "FLAVIA",
        "authorized_official_title_or_position": "CHAIR",
        "authorized_official_telephone_number": "310-825-6486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, PHD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "2059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "D34623",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL OF CA GROUP",
            "identifier": "02059",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.