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General NPI Number Information
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NPI Number | 1467667618
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Entity Type | Organization
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Legal Business Name | UCLA PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 10833 LE CONTE AVE 20-137
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City | LOS ANGELES
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State | CA
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Zip | 90095-1668
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Country | US
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Telephone | 310-825-8755
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Fax |
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Provider Business Mailing Address
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Address Line | 10833 LE CONTE AVE. CHS 23-021A
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City | LOS ANGELES
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State | CA
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Zip | 90095-1668
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Country | US
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Telephone | 310-825-8578
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE PROFESSOR
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Name | NINI TRAN
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Credential | DDS
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Telephone | 310-825-3578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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