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Widodo & Lee DDS A Professional Dental Corp

Dental Clinic/Center in Pomona, CA · enumerated 2012 · authorized official Andre Widodo, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1245589282

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Registry record

Entity type Organization (Type 2)
Legal business name Widodo & Lee DDS A Professional Dental Corp
Practice address 2112 S Garey Ave Ste A, Pomona, CA, 91766
Phone (909) 590-5600
Fax (909) 590-5606
Enumeration date Sep 6, 2012
Last updated in NPPES Sep 6, 2012

Taxonomy & classification

261QD0000X Dental Clinic/Center Ambulatory Health Care Facilities · License 46152 (CA) Primary

Authorized official

Name Andre Widodo
Title Owner
Phone (909) 590-5600

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Widodo & Lee DDS A Professional Dental Corp?
The NPI for Widodo & Lee DDS A Professional Dental Corp is 1245589282, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Widodo & Lee DDS A Professional Dental Corp?
NPPES lists Andre Widodo (Owner) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-09-06.