Mr. Soedharsono Judo is a Pomona, California based Dentist who is specialized in
Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Mr. Soedharsono Judo is
34127 for Dentistry in California. His current practice location is
1087 North Park Avenue, Pomona. Patients can reach him at
909-629-0201.
Mr. Soedharsono Judo is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Mr. Soedharsono Judo speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Mr. Soedharsono Judo |
| Specialization: | Dentist |
| Gender: | Male |
| Credentials: | DDS |
| Accepts Medicare Assignment: | No |
| Practice Address: | 1087 North Park Avenue, Pomona,
California, 91768-3026 |
| Phone: | 909-629-0201 |
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 are as mentioned below.
| NPI Number: | 1093873218 |
| NPI Enumeration Date: | 04 Dec, 2006 |
| NPI Last Update On: | 08 Jul, 2007 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Soedharsono Judo are as mentioned below.
| License Number | Specialization | State | Status | |
| 34127 | Dentistry | California | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Mr. Soedharsono Judo such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| G9044501 | Medicaid | California | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1087 North Park Avenue,
Pomona, California |
| Zip: | 91768-3026 |
| Phone Number: | 909-629-0201 |
Patients can reach Mr. Soedharsono Judo at
1087 North Park Avenue, Pomona, California or can
call to book an appointment on 909-629-0201.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.