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General NPI Number Information
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NPI Number | 1427919638
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Entity Type | Organization
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Legal Business Name | UCSF DENTISTRY SPECIALTY PRACTICES
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 110 PARK PLACE, SUITE 150
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City | SAN MATEO
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State | CA
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Zip | 94403
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Country | US
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Telephone | 415-476-1323
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Fax |
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Provider Business Mailing Address
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Address Line | 110 PARK PLACE, SUITE 150
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City | SAN MATEO
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State | CA
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Zip | 94403
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DEAN, UCSF SCHOOL OF DENTISTRY
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Name | MICHAEL REDDY
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Credential | DMD,DMSC
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Telephone | 415-476-1323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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