National Provider Identifier Database

PETER SUMARSONO PROFESSIONAL DENTAL CORPORATION
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

PETER SUMARSONO PROFESSIONAL DENTAL CORPORATION
4605 BARRANCA PARKWAY., 200
IRVINE, CA92604
Phone: 714-864-8261
Fax:
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X

* Indicates primary specialty

NPI Profile & details for PETER SUMARSONO PROFESSIONAL DENTAL CORPORATION

NPI Number 1326443920
Legal business name
LBN
PETER SUMARSONO PROFESSIONAL DENTAL CORPORATION
Authorized official CAROLINE SUMARSONO - (OFFICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 10/27/2014
Last updated 10/27/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: 40736

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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