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Organization
UNIVERSITY OF SOUTHERN CALIFORNIA
Active
Organization
UNIVERSITY OF SOUTHERN CALIFORNIA
Active
Other names
USC School of Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD DICKEY (SENIOR VICE PRESIDENT, ADMINISTRATI)
(213) 740-8184
Entity
Organization
Contact information
Practice address
925 W 34TH ST, ROOM #151, LOS ANGELES, CA 90089-0641
(213) 740-7405
(213) 740-4813
Mailing address
925 W 34TH ST, ROOM #151, LOS ANGELES, CA 90089-0641
(213) 740-7405
(213) 740-4813
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
126900000X
Dental Laboratory Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9117717
UNITED CONCORDIA
CA
01
—
DC6562
RAILROAD MEDICARE
CA
01
—
G0100701
HEALTHY FAMILIES
CA
01
—
G9059502
DENTICAL
CA
01
—
U0100701
DENTICAL
CA
01
—
ZZZ34010Z
BLUE CROSS
CA
01
—
ZZZ34010Z
BLUE SIELD
—
Enumeration date
11/08/2006
Last updated
03/08/2010
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