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PETER SUMARSONO PROFESSIONAL DENTAL CORPORATION NPI 1326443920


NPI Information

NPI: 1326443920
Provider Name: PETER SUMARSONO PROFESSIONAL DENTAL CORPORATION
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
4605 BARRANCA PARKWAY., 200
IRVINE, CA
ZIP 92604
Phone: (714) 864-8261
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PETER SUMARSONO PROFESSIONAL DENTAL CORPORATION is a preferred provider organization in Irvine, CA. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. PETER SUMARSONO PROFESSIONAL DENTAL CORPORATION NPI is 1326443920. The provider is registered as an organization entity type.

The provider's business location address is:

4605 BARRANCA PARKWAY., 200
IRVINE, CA
ZIP 92604
Phone: (714) 864-8261

The provider's authorized official is Caroline Sumarsono .
The authorized official title is Office Manager and has the following contact phone number (714) 864-8261.

The enumeration date for this NPI number is 10/27/2014 and was last updated on 10/27/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305R00000XPreferred Provider Organization40736CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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