Dr. Tjahjadi Andy Kusumo is a Anaheim, California based Dentist who is specialized in General Practice Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Tjahjadi Andy Kusumo is 49917 for General Practice Dentistry in California. His current practice location is 501 N Brookhurst St Ste 100, Anaheim. Patients can reach him at 714-392-8283.
Dr. Tjahjadi Andy Kusumo 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:
Dr. Tjahjadi Andy Kusumo 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:
Dr. Tjahjadi Andy Kusumo
Specialization:
Dentist
Gender:
Male
Credentials:
DDS
Accepts Medicare Assignment:
No
Practice Address:
501 N Brookhurst St Ste 100, Anaheim, California, 92801-5202
Phone:
714-392-8283
Fax:
888-498-3823
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:
1245366020
NPI Enumeration Date:
26 Feb, 2007
NPI Last Update On:
15 Aug, 2025
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Tjahjadi Andy Kusumo are as mentioned below.
License Number
Specialization
State
Status
49917
General Practice Dentistry
California
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Tjahjadi Andy Kusumo such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
D49917
Other
California
DENTIST
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
222 S Emerald St, Anaheim, California
Zip:
92804-2525
Phone Number:
949-769-0495
Fax Number:
714-400-2085
Patients can reach Dr. Tjahjadi Andy Kusumo at 501 N Brookhurst St Ste 100, Anaheim, California or can call to book an appointment on 714-392-8283. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.