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KEVIN MICHAEL HADIDJAJA
NPI 1538765086
Dentist - General Practice in Los Angeles, CA

Active since December 09, 2020
905 E 2ND ST APT 336, LOS ANGELES, CA 90012(310) 347-8432 Get Directions Write a Review

NPPES record last updated: December 9, 2020. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Kevin Michael Hadidjaja NPPES

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

KEVIN MICHAEL HADIDJAJA (NPI 1538765086) is an individual general practice provider in Los Angeles, California, licensed in California (DDS105752) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1538765086
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameKEVIN MICHAEL HADIDJAJA
Location Address905 E 2ND ST APT 336Los Angeles, CA 90012-4465
Mailing Address905 E 2nd St Apt 336Los Angeles, CA 90012-4465 · (310) 347-8432
Phone(310) 347-8432
Sole ProprietorNo
Enumeration DateDecember 9, 2020
NPPES CertifiedDecember 9, 2020
✔ NPI 1538765086 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · DDS105752
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.
905 E 2ND ST APT 336, Los Angeles, CA 90012
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

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 Kevin Hadidjaja's NPI number?

The NPI number for Kevin Hadidjaja is 1538765086. It was assigned to this individual provider in the NPPES registry on December 9, 2020.

Where is Kevin Hadidjaja located?

Kevin Hadidjaja practices at 905 E 2nd St Apt 336, Los Angeles, CA 90012. The listed phone number is (310) 347-8432.

What is Kevin Hadidjaja's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Kevin Hadidjaja accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and HRI Dental & Vision and 4 other insurers list Kevin Hadidjaja 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 Kevin Hadidjaja was last updated on December 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.