NPIMap

Organization Active NPI

H. Hadidjaja, DDS Inc.

  • Dentist
  • Huntington Park, CA
National Provider Identifier
1063815256
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41834 Issued in CA
Legal business name
H. HADIDJAJA, DDS INC.
Practice address
3122 E Florence Ave
Huntington Park, CA 90255-5830
Phone
(323) 588-0001
Fax
(999) 999-9999
NPI assigned
Oct 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Authorized official

Name
Dr. Hami Hadidjaja, D.D.S.NPI 1427170794
Title
President
Phone
(323) 588-0001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 41834 CA Primary

Addresses

Primary practice location

3122 E Florence Ave
Huntington Park, CA 90255-5830

Mailing address

3122 E Florence Ave
Huntington Park, CA 90255-5830
Phone (323) 588-0001

National Provider Directory

National Provider Directory

Locations

3122 E Florence Ave
Huntington Park, CA 90255
Phone (323) 588-0001

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1063815256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3122 E FLORENCE AVE",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902555830",
            "telephone_number": "323-588-0001",
            "fax_number": "999-999-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3122 E FLORENCE AVE",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902555830",
            "telephone_number": "323-588-0001",
            "fax_number": "999-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H. HADIDJAJA, DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "HADIDJAJA",
        "authorized_official_first_name": "HAMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-588-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "41834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.