PETER SUMARSONO PROFESSIONAL DENTAL CORPORATION


Address: 9110 Adams Avenue, Huntington Beach, CA 92646
Phone: 7149684487

PETER SUMARSONO PROFESSIONAL DENTAL CORPORATION (NPI# 1033596788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033596788
Entity Type Organization
Organization Name PETER SUMARSONO PROFESSIONAL DENTAL CORPORATION
Practice Address 9110 Adams Avenue
Huntington Beach
CA 92646
Mailing Address 18543 Yorba Linda Blvd. #250
Yorba Linda
CA 92886
Practice Telephone 7149684487
Practice Fax Number 7149681146
Enumeration Date 2015-05-01
Last Update Date 2015-05-01
Authorized Official Name PETER ROBERTSON SUMARSONO (DENTIST)
Authorized Official Telephone 7148648261
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 305R00000X Preferred Provider Organization 40736 CA Managed Care Organizations

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1326443920 Peter Sumarsono Professional Dental Corporation Preferred Provider Organization 4605 Barranca Parkway., 200, Irvine, CA 92604 2014-10-27

Office Location

Street Address 9110 ADAMS AVENUE
City HUNTINGTON BEACH
State CA
Zip Code 92646

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255809000 Geraldine Anne Loughran-beutler Registered Nurse 9941 Hot Springs Dr, Huntington Beach, CA 92646 2018-11-09
1740646934 Srinivasa Murthy Pediatrics 8851 Baywood Drive, Huntington Beach, CA 92646 2016-01-05
1134584436 A & A Pharmacies Inc Durable Medical Equipment & Medical Supplies 9106 Adams Ave, Huntington Beach, CA 92646 2015-12-31
1053776302 A&a Pharmacies, Inc. Pharmacy 9106 Adams Avenue, 9108, Huntington Beach, CA 92646 2015-12-30
1194101956 The Piercy Group, Inc. Physical Therapist 19032 Magnolia St. B, Huntington Beach, CA 92646 2015-08-04
1427446640 Celline Thanh Pham Dds, Inc Dentist 19059 Bushard St, Huntington Beach, CA 92646 2014-12-23
1538565320 Orange County Urgent Care #3 Inc. Clinic/Center 10026-10028 Adams Avenue, Huntington Beach, CA 92646 2014-11-06
1184065948 Megan Price Behavioral Analyst 8902 Albatross, Huntington Beach, CA 92646 2013-07-09
1699029504 Jean-pierre Jacques Dufour Family Medicine 8952 Faust Cir., Huntington Beach, CA 92646 2012-10-30
1518237122 Yvette Thuy Diroll Pharmacist 19001 Brookhurst St., Huntington Beach, CA 92646 2012-01-12
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Taxonomy Information

Taxonomy Code 305R00000X
Grouping Managed Care Organizations
Classification Preferred Provider Organization

Taxonomy Definition

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.
Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912144114 Tom Vu Dental Corp Preferred Provider Organization 7171 Warner Ave, Suite #c, Huntington Beach, CA 92647-5478 2009-01-10
1578938981 Beach Family Doctors Medical Group Preferred Provider Organization 9131 Adams Ave, Huntington Beach, CA 92648 2015-12-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1154961142 Hoag Physcian Partners Preferred Provider Organization 16148 Sand Canyon Ave Fl 2, Irvine, CA 92618-3700 2020-01-08
1356806525 Premierone Plus Aco Preferred Provider Organization 1210 N Jefferson St Ste D, Anaheim, CA 92807-1630 2019-02-01
1548730450 Mastour & Fard Dental Corp Preferred Provider Organization 587 N. Ventu Park Road., Suite C, Newberry Park, CA 91320 2018-12-04
1689151698 David W Schwartz Md A Medical Corporation Preferred Provider Organization 29645 Rancho California Rd Ste 105, Temecula, CA 92591 2018-07-23
1184100471 Care Allies Ipa, Inc Preferred Provider Organization 1211 W La Palma Ave Ste 309, Anaheim, CA 92801-2811 2018-07-19
1245723071 Pacific Associates Medical Group, Inc. Preferred Provider Organization 9900 Lakewood Blvd Ste 103, Downey, CA 90240-4039 2018-06-06
1821585266 Anthony Nguyen Dds Inc Preferred Provider Organization 1125 E 17th St Ste N156, Santa Ana, CA 92701-2215 2018-04-20
1275038051 Ryan Lange D.m.d. Inc. Preferred Provider Organization 17897 Macarthur Blvd Ste 100, Irvine, CA 92614-0532 2018-03-26
1649798190 Freedom Physicians Corporation Preferred Provider Organization 2295 Huntington Dr., Ste. D, San Marino, CA 91108 2017-09-05
1952835282 Dr. Jose Flores D.d.s Inc. Preferred Provider Organization 11510 Downey Ave, Downey, CA 90241 2017-04-13
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Competitor

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City HUNTINGTON BEACH
Zip Code 92646

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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