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

Kusumo Sumardi, DDS

Individual provider General Practice Dentistry · NPI 1811037435

Kusumo Sumardi, DDS is a General Practice Dentistry in LA Verne, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2007
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

1965 Foothill Blvd Ste L
LA Verne, CA 91750-3502
Phone: (909) 596-6500
Fax: (909) 596-8809
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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 41680 (CA)

Record details

NPI number1811037435
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedFebruary 6, 2007
Last updated in NPPESJuly 8, 2007
Mailing address3870 Grand Ave, Claremont, CA 91711-1454

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