1. Home
  2. Directory
  3. California
  4. La Verne
  5. Dentist
  6. NPI Profile

KUSUMO SUMARDI D.D.S.
NPI 1811037435
Dentist - General Practice in La Verne, CA

Active since February 06, 2007
1965 FOOTHILL BLVD, SUITE L, LA VERNE, CA 91750(909) 596-6500(909) 596-8809 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kusumo Sumardi D.d.s. NPPES

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

KUSUMO SUMARDI D.D.S. (NPI 1811037435) is an individual general practice provider in La Verne, California, licensed in California (41680) and active in the NPI registry since February 2007.

NPPES Registry Identity

NPI1811037435
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameKUSUMO SUMARDICredential: D.D.S.
Location Address1965 FOOTHILL BLVD, SUITE LLa Verne, CA 91750-3502
Mailing Address3870 Grand AveClaremont, CA 91711-1454 · (909) 621-9088
Phone(909) 596-6500
Fax(909) 596-8809
Sole ProprietorYes
Enumeration DateFebruary 6, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1811037435 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 · 41680
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.
1965 FOOTHILL BLVD, La Verne, CA 91750
Open in Google Maps ↗

Accepted Insurance

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

Other Providers at the Same Location NPPES

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

LIFESTYLE HEARING AID SOLUTIONS
Audiologist
1965 FOOTHILL BLVD
LA VERNE, CA 91750
Los Angeles County (909) 583-0550

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 Kusumo Sumardi's NPI number?

The NPI number for Kusumo Sumardi is 1811037435. It was assigned to this individual provider in the NPPES registry on February 6, 2007.

Where is Kusumo Sumardi located?

Kusumo Sumardi practices at 1965 Foothill Blvd Suite L, La Verne, CA 91750. The listed phone number is (909) 596-6500.

What is Kusumo Sumardi's specialty?

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

What insurance does Kusumo Sumardi accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Florida Combined Life and 1 other insurer list Kusumo Sumardi 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 Kusumo Sumardi was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.