Wijaya Sulaeman, D.d.s. is a Dental Clinic in San Bernardino, California. It is located at 25054 Base Line St, San Bernardino, CA and its contact number is 909-889-9591. The authorized person for Wijaya Sulaeman, D.d.s. is Dr. Audrey Indhira Sulaeman
who is Dentist of the clinic and their contact number is 909-889-9591. The primary license number for Wijaya Sulaeman, D.d.s. is 37166 (General Practice) in California. Wijaya Sulaeman, D.d.s. Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Wijaya Sulaeman, D.d.s. Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Wijaya Sulaeman, D.d.s.
Specialization:
General Practice Dentistry
Clinic Address:
25054 Base Line St, San Bernardino, California, 92410-4026
Phone:
909-889-9591
Fax:
909-889-8721
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Audrey Indhira Sulaeman
Position:
Dentist
Contact Number:
909-889-9591
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Wijaya Sulaeman, D.d.s. clinic are as mentioned below.
NPI Number:
1063537538
NPI Enumeration Date:
21 Mar, 2007
NPI Last Update On:
22 Aug, 2020
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Wijaya Sulaeman, D.d.s. are as mentioned below.
Specialization
License Number
State
Status
General Practice
37166
California
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
D37166
Medicaid
California
D44254
Medicaid
California
D48030
Medicaid
California
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Wijaya Sulaeman, D.d.s. 25054 Base Line St, San Bernardino, California
Zip:
92410-4026
Phone Number:
909-889-9591
Fax Number:
909-889-8721
Patients can reach Wijaya Sulaeman, D.d.s. at 25054 Base Line St, San Bernardino, California or can call to book an appointment on 909-889-9591. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 May, 2024.