Dr. Andre Widodo , DDS
Dentist - General Practice • Pomona, CA
Professional Overview & Biography Verified Profile Summary
Dr. Andre Widodo, DDS is a registered healthcare professional specializing in Dentist - General Practice in Pomona, CA. Practice services are available at 2112 S GAREY AVE STE A under active NPI credentials.
Practice Location & Contact Primary Location
2112 S Garey Ave Ste A
Pomona, CA 917665600
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Pomona, CA
Practicing in Pomona, CA (18734 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
CMS Verified: 2022-04-25NUCC Taxonomy Code: 1223G0001X
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.
Additional State Medicaid & Healthcare Payer Identifiers
Secondary Practice Locations
5562 Philadelphia St Ste 103
Chino, CA 917102482
Phone: 9096701100
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Dentist - General Practice
Doctor of Dental Surgery
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
NPI status registered as active in NPPES database
Registered at 2112 S GAREY AVE STE A, POMONA, CA 917665600 (Tel: 9095905600)
Registered at 2112 S GAREY AVE STE A, POMONA, CA 917665600 (Tel: 9095905600)
Recorded as ANDRE WIDODO, DDS
Dentist (License #46152 in CA)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
2112 S Garey Ave Ste A
Pomona, CA 917665600
Phone: 9095905600
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