NPIMap

Organization Active NPI

UCLA Dental Clinics

Doing business as UCLA Dental School

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1740392182
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
G01005 Issued in CA
Legal business name
UCLA DENTAL CLINICS
Doing business as
UCLA Dental School
Practice address
10833 Le Conte Ave
Suite 10137 CHS
Los Angeles, CA 90095-1668
Phone
(310) 825-9805
Fax
(310) 825-5252
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeffrey M Goldstein, PHD MBA
Title
Director Clinical Dental Center
Phone
(310) 794-5565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X G01005 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
Suite 10137 CHS
Los Angeles, CA 90095-1668

Mailing address

PO Box 951668
Los Angeles, CA 90095-1668
Phone (310) 825-9805

Other identifiers 2

IdentifierTypeStateIssuer
01005OtherCADELTA DENTAL
G01005OtherCADENTICAL

Other names 1

  • UCLA Dental School Doing business as

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
Ste 10137
Los Angeles, CA 90095
Phone (310) 825-9805

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740392182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 951668",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951668",
            "telephone_number": "310-825-9805",
            "fax_number": "310-825-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "SUITE 10137 CHS",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951668",
            "telephone_number": "310-825-9805",
            "fax_number": "310-825-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCLA DENTAL CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR CLINICAL DENTAL CENTER",
        "authorized_official_telephone_number": "310-794-5565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD MBA"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "G01005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "01005",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "G01005",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCLA Dental School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.