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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