Teeth 'R' US Children's Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

46120 Issued in CA

Legal business name

TEETH 'R' US CHILDREN'S DENTISTRY

Practice address

660 N Diamond Bar Blvd
Ste 288
Diamond Bar, CA 91765-1008

Phone

(909) 396-0107

Fax

(909) 396-0094

NPI assigned

Feb 11, 2015

Last updated

Sep 14, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Andriani Ongkorahardjo, D.D.S.NPI 1902941669

Title

Owner

Phone

(909) 396-0107

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andriani Ongkorahardjo, DDS

  • Pediatric Dentistry
  • Diamond Bar, CA
  • NPI 1902941669
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1063803054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 N DIAMOND BAR BLVD",
            "address_2": "STE 288",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651008",
            "telephone_number": "909-396-0107",
            "fax_number": "909-396-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 N DIAMOND BAR BLVD",
            "address_2": "STE 288",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651008",
            "telephone_number": "909-396-0107",
            "fax_number": "909-396-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEETH 'R' US CHILDREN'S DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "ONGKORAHARDJO",
        "authorized_official_first_name": "ANDRIANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-396-0107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "46120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ta Yang
• Matthew Lee Tajima
• Hong-Ming Tang, D.D.S. M.S.
• Jude Muluh Tasinga, PMHNP
• Erica Katharina Taylor, SLP
• Marco Tejeda, PTA
• George W Than, D.C.
• Deslin Thomas, M.D
• Arlen Thong
• Chad Tiradeau

• Dental Clinic/Center in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.