NPIMap

Organization Active NPI

UCLA Hospital Dentistry

  • Special Hospital
  • Los Angeles, CA
National Provider Identifier
1730363763
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
License
D19585 Issued in CA
Legal business name
UCLA HOSPITAL DENTISTRY
Practice address
UCLA Hospital Dentistry
10833 Le Conte Ave. CHS BLDG Room A0-156B
Los Angeles, CA 90095-0001
Phone
(310) 206-8775
Fax
(310) 206-4201
NPI assigned
Dec 27, 2007
Last updated
Dec 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Authorized official

Name
Ms. Rosa M. Gonzalez, MSO III
Title
Operations Manager
Phone
(310) 206-6926

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X D19585 CA Primary

Addresses

Primary practice location

UCLA Hospital Dentistry
10833 Le Conte Ave. CHS BLDG Room A0-156B
Los Angeles, CA 90095-0001

Mailing address

P.O. Box 84582
UCLA Hospital Dentistry
Los Angeles, CA 90073
Phone (310) 206-8775

Other identifiers 1

IdentifierTypeStateIssuer
G91297-01MedicaidCA

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
Rm A156B
Los Angeles, CA 90095
Phone (310) 206-8775

Practitioners & affiliated clinicians

Practitioners 1

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": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1730363763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 84582",
            "address_2": "UCLA HOSPITAL DENTISTRY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90073",
            "telephone_number": "310-206-8775",
            "fax_number": "310-206-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCLA HOSPITAL DENTISTRY",
            "address_2": "10833 LE CONTE AVE. CHS BLDG ROOM A0-156B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-206-8775",
            "fax_number": "310-206-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCLA HOSPITAL DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "310-206-6926",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSO III"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "CA",
            "license": "D19585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G91297-01",
            "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 Dec 27, 2007; 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.