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DR. RIDWAN SUDIRGO D.D.S
NPI 1811037443
Dentist - General Practice in Montebello, CA

Active since February 06, 2007
2218 W BEVERLY BLVD, MONTEBELLO, CA 90640(323) 721-6221(323) 721-8641 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Ridwan Sudirgo D.d.s NPPES

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

DR. RIDWAN SUDIRGO D.D.S (NPI 1811037443) is an individual general practice provider in Montebello, California, licensed in California (36010) and active in the NPI registry since February 2007.

NPPES Registry Identity

NPI1811037443
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. RIDWAN SUDIRGOCredential: D.D.S
Location Address2218 W BEVERLY BLVDMontebello, CA 90640-2302
Mailing AddressPo Box 3066Montebello, CA 90640-8366 · (323) 721-6221 · Fax (323) 721-8641
Phone(323) 721-6221
Fax(323) 721-8641
Sole ProprietorYes
Enumeration DateFebruary 6, 2007
Last NPPES UpdateJuly 9, 2007
✔ NPI 1811037443 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 · 36010
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.
2218 W BEVERLY BLVD, Montebello, CA 90640
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Other Identifiers 1

MedicaidB 36010-01CA

Accepted Insurance

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

JONATHAN K. LEE DDS, APC
Clinic/Center (Dental)
2218 W BEVERLY BLVD
MONTEBELLO, CA 90640
Los Angeles County (310) 500-9647

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 Ridwan Sudirgo's NPI number?

The NPI number for Ridwan Sudirgo is 1811037443. It was assigned to this individual provider in the NPPES registry on February 6, 2007.

Where is Ridwan Sudirgo located?

Ridwan Sudirgo practices at 2218 W Beverly Blvd, Montebello, CA 90640. The listed phone number is (323) 721-6221.

What is Ridwan Sudirgo's specialty?

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

What insurance does Ridwan Sudirgo accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Ridwan Sudirgo 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 Ridwan Sudirgo was last updated on July 9, 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.