Healthcare Provider Details

I. General information

NPI: 1326300591
Provider Name (Legal Business Name): RAYMOND M KLEIN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6167 BRISTOL PKWY STE 106
CULVER CITY CA
90230-6611
US

IV. Provider business mailing address

6167 BRISTOL PKWY STE 106
CULVER CITY CA
90230-6611
US

V. Phone/Fax

Practice location:
  • Phone: 310-329-9009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number61350
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: