# REGENTS OF UNIVERSITY OF CALIFORNIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UCLA Dental Radiology Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356476865
- **Authorized official:** DR. SANJAY MALLYA DDS (PROFESSOR)
- **Authorized official phone:** (310) 825-1689

## Contact information

- **Practice address:** 10833 LE CONTE AVE, CHS 10 -165, LOS ANGELES, CA 90095-1668
- **Practice address phone:** (310) 825-5634
- **Practice address fax:** (310) 206-2748
- **Mailing address:** 10833 LE CONTE AVE., CHS 53-068, LOS ANGELES, CA 90095-1668
- **Mailing address phone:** (310) 825-1689
- **Mailing address fax:** (310) 825-7232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223X0008X | Oral and Maxillofacial Radiology Dentistry | — | CA | Yes |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 10/02/2025