# UC REGENTS OF THE UNIVERSITY OF MAXILLOFACIAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UCLA Maxillofacial Prosthetics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124238910
- **Authorized official:** ELENI D. ROUMANAS DDS (PROFESSOR)
- **Authorized official phone:** (310) 794-9858

## Contact information

- **Practice address:** 10833 LE CONTE AVE, BOX 951668, LOS ANGELES, CA 90095-1668
- **Practice address phone:** (310) 794-9858
- **Practice address fax:** (310) 206-4201
- **Mailing address:** 10833 LE CONTE AVE \# A0-0156, LOS ANGELES, CA 90095-1668
- **Mailing address phone:** (310) 206-6926
- **Mailing address fax:** (310) 206-4201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | 37489 | CA | Yes |

## Other

- **Enumeration date:** 05/23/2007
- **Last updated:** 03/10/2014