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Dr. Ridwan Sudirgo, DDS
General Practice Dentistry in Montebello, California
NPI 1811037443

Ridwan Sudirgo is a General Practice Dentistry based in Montebello, CA and is specialized in General Practice. Ridwan Sudirgo practices in Montebello, CA and has the professional credentials of DDS. The NPI Number for Ridwan Sudirgo is 1811037443 and holds a License No. 36010 (California).

The current practice location address for Ridwan Sudirgo is 2218 W Beverly Blvd, Montebello, CA and can be reached out via phone at 323-721-6221 and via fax at 323-721-8641.

Location: 2218 W Beverly Blvd, Montebello, CA, 90640-8366
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811037443
Provider Name
Ridwan Sudirgo
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
2218 W Beverly Blvd, Montebello, CA, 90640-8366
Phone Number
323-721-6221
Fax Number
323-721-8641
Provider Enumeration Date
02/06/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
B 36010-01 05 CA
institution
Provider Business Practice Location Address Details
Address
2218 W Beverly Blvd
City
Montebello
State
California
Zip
90640-2302
Phone Number
323-721-6221
Fax Number
323-721-8641
person
Provider Business Mailing Address Details
Address
2218 W Beverly Blvd
City
Montebello
State
California
Zip
90640-2302
Phone Number
323-721-6221
Fax Number
323-721-8641
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
36010 (California)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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