Individual provider Active NPI

Vivek Shetty, DDS, DR.MED.DENT.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Los Angeles, CA
National Provider Identifier
1851417737
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
41040 Issued in CA
Practice address
10833 Le Conte Ave
Suite Ao-156
Los Angeles, CA 90095-1668
Phone
(310) 825-0834
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 41040 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
Suite Ao-156
Los Angeles, CA 90095-1668

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Phone (310) 825-0834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110908002064 CA Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 9638349269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 UCLA Medical PLZ
Suite 460
Los Angeles, CA 90024-7000
Phone (310) 443-8999

10833 Le Conte Ave
Los Angeles, CA 90095-3075

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jan 1, 2025 Accepting new patients
Regents of the University of California Oral & Maxillofacial Surgery Current Accepting new patients
The Regents of the University of California CurrentSince Jun 6, 2011 Accepting new patients
Regents of the University of California CurrentSince Jan 1, 2025 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

5201 Truxtun Ave
Bakersfield, CA 93309
Phone (661) 328-5565

100 UCLA Medical Plz
Ste 460
Los Angeles, CA 90024
Phone (310) 443-8999

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

10833 Le Conte Ave
Ste AO156
Los Angeles, CA 90095
Phone (310) 825-0834

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

10833 Le Conte Ave
#A156
Los Angeles, CA 90095
Phone (310) 825-0834

10833 Le Conte Ave
Rm Ao
Los Angeles, CA 90095
Phone (310) 825-0834

2655 1st St
Ste 300
Simi Valley, CA 93065
Phone (805) 578-8550

Interoperability endpoints

  • Direct secure messaging: vshetty10349@direct.uclahealth.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1851417737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-825-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "SUITE AO-156",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951668",
            "telephone_number": "310-825-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "VIVEK",
        "credential": "DDS, DR.MED.DENT.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "41040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.