Wijaya Sulaeman, D.d.s. - Dental Clinic in San Bernardino, CA

Wijaya Sulaeman, D.d.s. is a dental clinic (Dentist - General Practice) in San Bernardino, California. The current practice location for Wijaya Sulaeman, D.d.s. is 25054 Base Line St, San Bernardino, California. For appointments, you can reach them via phone at (909) 889-9591. The mailing address for Wijaya Sulaeman, D.d.s. is 25054 Base Line St, San Bernardino, California and phone number is (909) 889-9591.

Wijaya Sulaeman, D.d.s. is licensed to practice in California (license number 37166) and its NPI number is 1063537538. This medical practice does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at (909) 889-9591.

Contact Information

Wijaya Sulaeman, D.d.s.
25054 Base Line St
San Bernardino
CA 92410-4026
(909) 889-9591
(909) 889-8721

Dental Care Clinic Profile

Full NameWijaya Sulaeman, D.d.s.
SpecialityDentist - General Practice
Location25054 Base Line St, San Bernardino, California
Authorized Official Name and PositionAudrey Indhira Sulaeman (DENTIST)
Authorized Official Contact9098899591
Accepts Medicare InsuranceThis clinic does not participate in Medicare Program.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Wijaya Sulaeman, D.d.s.
25054 Base Line St
San Bernardino
CA 92410-4026

Ph: (909) 889-9591
Wijaya Sulaeman, D.d.s.
25054 Base Line St
San Bernardino
CA 92410-4026

Ph: (909) 889-9591

NPI Details:

NPI Number1063537538
Provider Enumeration Date03/21/2007
Last Update Date08/22/2020

Medical Identifiers

Medical identifiers for Wijaya Sulaeman, D.d.s. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063537538NPI-NPPES
D37166MedicaidCA
D44254MedicaidCA
D48030MedicaidCA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223G0001XDentist - General Practice 37166 (California)Primary

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