DR. SANJAY M MALLYA B.D.S. NPI 1538158043

NPI Information

NPI: 1538158043
Provider Name: DR. SANJAY M MALLYA, B.D.S.
Classification: Dentist - 1223X0008X
Entity Type: Individual

Specialization: Oral and Maxillofacial Radiology

Address:
10833 LE CONTE AVE
CHS 10-165
LOS ANGELES, CA
ZIP 90095
Phone: (310) 825-5634
Get Directions

DR. Sanjay M Mallya, B.D.S. is an oral and maxillofacial radiology dentist in Los Angeles, CA. The provider is the specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. DR. Sanjay M Mallya, B.D.S. NPI is 1538158043. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10833 LE CONTE AVE
CHS 10-165
LOS ANGELES, CA
ZIP 90095-668
Phone: (310) 825-5634
Fax: (310) 206-2748

The enumeration date for this NPI number is 10/18/2005 and was last updated on 3/2/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223X0008X	Dentist	Oral and Maxillofacial Radiology	9026	CONNECTICUT	No
2	1223X0008X	Dentist	Oral and Maxillofacial Radiology	SP-251	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	004010807	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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