Individual provider · Type 1 NPI

Sanjay M. Mallya, B.D.S.

Oral and Maxillofacial Radiology Dentistry · Los Angeles, CA

NPI number 1538158043 Active

Practice location

10833 Le Conte Ave, Chs 10-165
Los Angeles, CA 90095-1668

Fax (310) 206-2748

Mailing address

P.o. Box 951668, Chs 10-165
Los Angeles, CA 90095-1668

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Radiology Dentistry 1223X0008X9026 (CT)
Oral and Maxillofacial Radiology Dentistry Primary 1223X0008XSP-251 (CA)

Oral and Maxillofacial Radiology Dentistry: 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.

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About NPI 1538158043

Sanjay M. Mallya, B.D.S.'s National Provider Identifier is 1538158043, issued on Oct 18, 2005. The primary taxonomy on file is Oral and Maxillofacial Radiology Dentistry (1223X0008X), and the practice location is in Los Angeles, CA. The record was last updated on Mar 2, 2010.