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

Dr. Santoso Tirtawidjaja, DDS

Individual provider Dentist · NPI 1295896850

Dr. Santoso Tirtawidjaja, DDS is a Dentist in Los Angeles, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2006
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

1200 W Martin Luther King Blvd
Los Angeles, CA 90037
Phone: (323) 295-8306
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 38931 (CA)

Record details

NPI number1295896850
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedDecember 13, 2006
Last updated in NPPESJuly 8, 2007

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