Healthcare Provider Details

I. General information

NPI: 1003038142
Provider Name (Legal Business Name): CLARICE LAW EYRE DMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLARICE SI-MIN LAW DMD, MS

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 UCLA MEDICAL PLZ STE 350
LOS ANGELES CA
90095-0001
US

IV. Provider business mailing address

1248 S SYCAMORE AVE
LOS ANGELES CA
90019-1533
US

V. Phone/Fax

Practice location:
  • Phone: 310-794-5750
  • Fax:
Mailing address:
  • Phone: 323-931-7264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number43456
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number43456
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: