Search › California › 122300000X
Damita Wiredja, DDA
NPI 1740949056 · on the registry since 2021 · sole proprietor
Practice
- Address
- 6100 Atlantic Blvd Ste I
Maywood, CA 90270 - Phone
- (323) 771-7551
- Fax
- (323) 771-7881
- Organisation at this address
- Heru Wiredja,Dds,Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-01-05
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