Search › California › 1223G0001X
Tjahjadi Kusumo, DDS
NPI 1245366020 · on the registry since 2007 · sole proprietor
Practice
- Address
- 501 N Brookhurst St Ste 100
Anaheim, CA 92801 - Phone
- (714) 392-8283
- Fax
- (888) 498-3823
- Organisation at this address
- Andy Kusumo Dds Inc
Al-Shifa Hospice Care
Sentient Surgical Monitoring Llc
Al-Shifa Home Health Care AgencyInferred from a shared address, not stated in the registry. - Clinicians at this address
- 54
Additional practice sites
- 222 S Emerald St, Anaheim, CA
Registry record
- Primary taxonomy
- 1223G0001X
1223G0001X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-08-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California