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Organization
UCLA VENICE DENTAL CENTER
Active
Organization
UCLA VENICE DENTAL CENTER
Active
Other names
UCLA School of Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC HAYASETI DDS (ASSOCIATE CLINICAL PROFESSOR)
(310) 825-4855
Entity
Organization
Contact information
Practice address
323 LINCOLN BLVD, VENICE, CA 90291-2842
(310) 392-4103
Mailing address
10833 LE CONTE AVE, CHS 33-019, LOS ANGELES, CA 90095-1668
(310) 825-4855
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G01004-01
DENTI-CAL
CA
Enumeration date
03/15/2007
Last updated
10/02/2025
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