Kevin Michael Hadidjaja (NPI# 1538765086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1538765086 |
| Entity Type | Individual |
| Full Name | Kevin Michael Hadidjaja |
| Gender | Male |
| Practice Address |
905 E 2nd St Apt 336 Los Angeles CA 90012-4465 |
| Practice Telephone | 3103478432 |
| Mailing Address |
905 E 2nd St Apt 336 Los Angeles CA 90012-4465 |
| Mailing Telephone | 3103478432 |
| Sole Proprietor | No, this individual is not a Sole Proprietor |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2020-12-09 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 1223G0001X | Dentist · General Practice | Dental Providers | DDS105752 | CA |
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063008233 | Woojin Lee | Dentist | 3060 W Olympic Blvd Apt 514, Los Angeles, CA 90006-3839 | 2020-12-11 |
| 1508462649 | D Park Mph Dental, Inc. | Dentist | 12021 Wilmington Ave Ste 1100, Los Angeles, CA 90059-3019 | 2020-12-04 |
| 1316542798 | Navid Esfandi | Dentist | 1944 Glendon Ave Apt 104, Los Angeles, CA 90025-4621 | 2020-12-02 |
| 1528662921 | Life Power Group | Dentist | 11901 Santa Monica Blvd Ste 203, Los Angeles, CA 90025-2783 | 2020-11-25 |
| 1295349082 | Reza Mehr | Dentist | 900 W Temple St Apt 506, Los Angeles, CA 90012-4551 | 2020-08-31 |
| 1396355590 | Kamyar Moradian | Dentist | 9201 Venice Blvd, Los Angeles, CA 90034-3324 | 2020-08-04 |
| 1669096160 | Leora H Sheily Dds PC | Dentist | 4852 Melrose Ave, Los Angeles, CA 90029-3736 | 2020-06-01 |
| 1013539535 | Smit Dangaria Dds Phd Inc | Dentist | 1325 S Harvard Blvd, Los Angeles, CA 90006-4229 | 2020-05-07 |
| 1912530585 | Sara Bahri Sabokpey | Dentist | 2001 Stradella Rd, Los Angeles, CA 90077-2322 | 2020-02-21 |
| 1518504497 | Jonathan Dye | Dentist | 1626 Palo Alto St Apt 102, Los Angeles, CA 90026-5052 | 2019-12-10 |
| Find all providers in LOS ANGELES | ||||
| Street Address |
905 E 2ND ST APT 336 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90012-4465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538654124 | Los Angeles County Children and Families First - Proposition 10 Commis | Case Management | 750 N. Alameda Street, Suite 300, Los Angeles, CA 90012 | 2018-06-26 |
| 1750886511 | Pain Control Clinic | Acupuncturist | 321 E. 1st St. #220, Los Angeles, CA 90012 | 2018-03-26 |
| 1891224325 | Brenda D Sazo | Community Health Worker | 1000 N. Alameda St, # 350, Los Angeles, CA 90012 | 2017-06-08 |
| 1740719012 | Fatemeh Arabpour | Dentist | 505 N Figueroa Apt #534, Los Angeles, CA 90012 | 2017-06-08 |
| 1033667662 | Olga Witrago | Case Manager/Care Coordinator | 701 W Cersar Chavez Suite 201, Los Angeles, CA 90012 | 2016-09-12 |
| 1902269962 | Samantha Martinez | Licensed Practical Nurse | 701 West Cesar Chavez Av, Los Angeles, CA 90012 | 2016-03-29 |
| 1760847313 | Maria Emilia Manosa Rosales | Social Worker | 701 W. Cesar Chavez Ave., Los Angeles, CA 90012 | 2015-12-28 |
| 1609242999 | Hilary Adams | Psychologist | 250 E 1st St Ste 300, Los Angeles, CA 90012 | 2015-08-20 |
| 1831586288 | Thanh Ngoc Nguyen Trinh | Nurse Practitioner | 180 N Los Angeles St, Los Angeles, CA 90012 | 2015-04-23 |
| 1760880827 | Bertha Regina Garcia | Licensed Vocational Nurse | 701 W. Cesar E. Chavez Ave Suite201, Los Angeles, CA 90012 | 2014-12-05 |
| Find all providers in zip 90012 | ||||
| City | LOS ANGELES |
| Zip Code | 90012 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.