Andy Kusumo Dds Inc

LBN: Andy Kusumo Dds Inc
Andy Kusumo Dds Inc is an health care organization with primary practice located at 501 N Brookhurst St Ste 100 , Anaheim CA 92801-5202. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Andy Kusumo Dds Inc can be contacted via phone (657) 201-3084, or through Kusumo, Tjahjadi Andy via phone (949) 769-0495.

Contact Information

Primary practice address
501 N Brookhurst St Ste 100 Anaheim CA 92801-5202
Phone: (657) 201-3084
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kusumo, Tjahjadi Andy Doctor of Dental Surgery (DDS)
Phone: (949) 769-0495

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 49917 California

Profile Details

NPI number 1255721254
LBN Legal business name Andy Kusumo Dds Inc
DBA Doing business as
Authorized official Kusumo, Tjahjadi Andy Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 28th, 2015
Last updated Jan 28th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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