Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Patricia Hadiwidjaja Gusti, DDS

Individual provider General Practice Dentistry · NPI 1740578467

Dr. Patricia Hadiwidjaja Gusti, DDS is a General Practice Dentistry in Fullerton, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2011
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

1012 E Bastanchury Rd
Fullerton, CA 92835-2782
Phone: (714) 257-1220
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 60534 (CA)

Record details

NPI number1740578467
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorYes
NPI enumeratedJuly 15, 2011
Last updated in NPPESJanuary 17, 2024
Certification dateJanuary 17, 2024

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