WIDODO & LEE DDS A PROFESSIONAL DENTAL CORP
NPI 1245589282
Clinic/Center - Dental in Pomona, CA

Q: What is Widodo & Lee Dds A Professional Dental Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

Active since September 06, 2012

2112 S GAREY AVE STE A, POMONA, CA 91766(909) 590-5600(909) 590-5606 Get Directions Write a Review

NPPES record last updated: September 6, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Widodo & Lee Dds A Professional Dental Corp NPPES

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

WIDODO & LEE DDS A PROFESSIONAL DENTAL CORP (NPI 1245589282) is a healthcare organization registered as a dental in Pomona, California and active in the NPI registry since September 2012. The organization lists Andre Widodo, Owner, as its authorized official.

NPPES Registry Identity

NPI1245589282

Entity TypeOrganization

Primary Taxonomy261QD0000X

Legal Business NameWIDODO & LEE DDS A PROFESSIONAL DENTAL CORP

Location Address2112 S GAREY AVE STE APomona, CA 91766

Mailing Address2112 S Garey Ave Ste APomona, CA 91766 · (909) 590-5600 · Fax (909) 590-5606

Phone(909) 590-5600

Fax(909) 590-5606

Organization SubpartNo

Authorized OfficialAndre WidodoOwner · (909) 590-5600

Enumeration DateSeptember 6, 2012

✔ NPI 1245589282 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities

Taxonomy Code261QD0000X

License✔ Licensed in CA · 46152

2112 S GAREY AVE STE A, Pomona, CA 91766

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 2

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

DR. JEFFREY LEE DDS

Dentist (General Practice)

2112 S GAREY AVE STE A
POMONA, CA 91766

Los Angeles County (909) 590-5600

DR. ANDRE WIDODO DDS

Dentist (General Practice)

2112 S GAREY AVE STE A
POMONA, CA 91766

Los Angeles County (909) 590-5600

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 Widodo & Lee Dds A Professional Dental Corp's NPI number?

The NPI number for Widodo & Lee Dds A Professional Dental Corp is 1245589282. It was assigned to this organization in the NPPES registry on September 6, 2012.

Where is Widodo & Lee Dds A Professional Dental Corp located?

Widodo & Lee Dds A Professional Dental Corp is located at 2112 S Garey Ave Ste A, Pomona, CA 91766. The listed phone number is (909) 590-5600.

What is Widodo & Lee Dds A Professional Dental Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

What insurance does Widodo & Lee Dds A Professional Dental Corp accept?

Health plans from UnitedHealthcare list Widodo & Lee Dds A Professional Dental Corp as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Widodo & Lee Dds A Professional Dental Corp was last updated on September 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.