All Medicaid billing entities listing ONGKORAHARDJO, ANDRIANI (OWNER) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| California | 1 | $1.15M |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | TEETH 'R' US CHILDREN'S DENTISTRY | DIAMOND BAR, CA | Dental Clinic/Center | $1.15M |