MR. SOEDHARSONO JUDO DDS
NPI 1093873218
Dentist in Pomona, CA

Active since December 04, 2006
1087 NORTH PARK AVENUE, POMONA, CA 91768(909) 629-0201 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Soedharsono Judo Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. SOEDHARSONO JUDO DDS (NPI 1093873218) is an individual dentist in Pomona, California, licensed in California (34127) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1093873218
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameMR. SOEDHARSONO JUDOCredential: DDS
Location Address1087 NORTH PARK AVENUEPomona, CA 91768-3026
Mailing Address1087 North Park AvenuePomona, CA 91768-3026 · (909) 629-0201
Sole ProprietorNo
Enumeration DateDecember 4, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1093873218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License Licensed in CA · 34127
Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1087 NORTH PARK AVENUE, Pomona, CA 91768

Other Identifiers 1

MedicaidG9044501CA

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist
1087 NORTH PARK AVENUE
POMONA, CA 91768

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Soedharsono Judo's NPI number?

The NPI number for Soedharsono Judo is 1093873218. It was assigned to this individual provider in the NPPES registry on December 4, 2006.

Where is Soedharsono Judo located?

Soedharsono Judo practices at 1087 North Park Avenue, Pomona, CA 91768. The listed phone number is (909) 629-0201.

What is Soedharsono Judo's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Soedharsono Judo was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.