Judo, Teresita Jahja

Judo, Teresita Jahja is an individual health care provider with primary practice located at 1087 North Park Avenue , Pomona CA 91768-3026. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Judo, Teresita Jahja can be contacted via phone (909) 629-0201.

Contact Information

Primary practice address
1087 North Park Avenue Pomona CA 91768-3026
Phone: (909) 629-0201
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 36942 California

Profile Details

NPI number 1538235635
LBN Legal business name Judo, Teresita Jahja
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538235635 NPPES
California MEDICAID D36942

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