NPIMap

Organization Active NPI

UCLA School of Dentistry Esthetic

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1962545103
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21347 Issued in CA
Legal business name
UCLA SCHOOL OF DENTISTRY ESTHETIC
Practice address
10833 Le Conte Ave RM 33-064a
Los Angeles, CA 90095-3075
Phone
(310) 825-4736
Fax
(310) 267-2656
NPI assigned
Feb 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Authorized official

Name
Dr. Reuben Kim, DDS
Title
Division Chair
Phone
(310) 825-7312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 21347 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave RM 33-064a
Los Angeles, CA 90095-3075

Mailing address

10833 Le Conte Ave.
CHS 33-064
Los Angeles, CA 90095-1668
Phone (310) 825-4736

Other names 1

  • Esthetic Dentistry Department- Bill Yancey Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Regents of the Univ of Ca56 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

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

View all 14

Locations

10833 Le Conte Ave
Rm 33064A
Los Angeles, CA 90095
Phone (310) 825-4736

10833 Le Conte Ave
#33064
Los Angeles, CA 90095

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1962545103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE.",
            "address_2": "CHS 33-064",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951668",
            "telephone_number": "310-825-4736",
            "fax_number": "310-267-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE RM 33-064A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-825-4736",
            "fax_number": "310-267-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCLA SCHOOL OF DENTISTRY ESTHETIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_title_or_position": "DIVISION CHAIR",
        "authorized_official_telephone_number": "310-825-7312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "21347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Esthetic Dentistry Department- Bill Yancey",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Oct 9, 2025; 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.