Healthcare Provider Details

I. General information

NPI: 1700069051
Provider Name (Legal Business Name): UCLA SCHOOL OF DENTISRTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10833 LE CONTE AVE CHS 20-140
LOS ANGELES CA
90095-3075
US

IV. Provider business mailing address

10833 LE CONTE AVE. CHS 13-0600
LOS ANGELES CA
90095-1668
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-5161
  • Fax: 310-206-5349
Mailing address:
  • Phone: 310-825-4705
  • Fax: 310-206-5349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberD51398
License Number StateCA

VIII. Authorized Official

Name: DR. SUNIL KAPILA
Title or Position: ASSOCIATE DEAN, PROFESSOR
Credential: DDS
Phone: 310-825-4705