Kusumo Sumardi, D.D.S.

General Practice Dentistry · La Verne, CA

Individual Active NPI

NPI number 1811037435

Practice location

1965 Foothill Blvd
Suite L
La Verne, CA 91750-3502
Phone
(909) 596-6500
Fax
(909) 596-8809

Open in Google Maps

NPI record

NPI
1811037435
Entity type
Individual (Type 1)
Enumeration date
February 6, 2007
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 41680 CA

Mailing address

3870 Grand Ave
Claremont, CA 91711-1454
Phone
(909) 621-9088

About Dr. Sumardi

Kusumo Sumardi, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 1965 Foothill Blvd, Suite L, La Verne, CA 91750-3502. The NPI number 1811037435 was assigned on February 6, 2007 and the record was last updated on July 8, 2007.

Dr. Sumardi lists a license in the registry: #41680 (CA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kusumo Sumardi, D.D.S.?

The NPI number is 1811037435.

What is the phone number of Dr. Sumardi?

The phone number listed for the practice location is (909) 596-6500.

Where is Dr. Sumardi located?

1965 Foothill Blvd, Suite L, La Verne, CA 91750-3502.

What is the taxonomy code for Dr. Sumardi?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other General Practice Dentistry providers in La Verne

All General Practice Dentistry providers in La Verne, CA →