Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Widodo & Lee DDS a Professional Dental Corp

Organization Dental Clinic/Center · NPI 1245589282

Widodo & Lee DDS a Professional Dental Corp is a Dental Clinic/Center in Pomona, California. Licensed in California. Registered with an NPI since 2012.

Licensed in
CA
In the registry since
2012
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2112 S Garey Ave Ste A
Pomona, CA 91766
Phone: (909) 590-5600
Fax: (909) 590-5606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence 46152 (CA)

Record details

NPI number1245589282
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andre Widodo — Owner · (909) 590-5600
NPI enumeratedSeptember 6, 2012
Last updated in NPPESSeptember 6, 2012
Mailing address2112 S Garey Ave Ste A, Pomona, CA 91766

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