Kevin Michael Hadidjaja
Dentist (General Practice)

Address: 905 E 2nd St Apt 336, Los Angeles, CA 90012-4465
Phone: 3103478432

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).

Provider Overview

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

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 1223G0001X Dentist · General Practice Dental Providers DDS105752 CA

Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy 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.
Notes: Source: Academy of General Dentistry

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1528662921 Life Power Group Dentist 11901 Santa Monica Blvd Ste 203, Los Angeles, CA 90025-2783 2020-11-25
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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
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Find all providers in LOS ANGELES

Office Location

Street Address 905 E 2ND ST APT 336
State CA
Zip Code 90012-4465

Providers in the same zip code

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


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Zip Code 90012

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Dataset Information

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.