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Billing entities under WIDODO, ANDRE
Every Medicaid billing NPI that lists WIDODO, ANDRE (dentist / owner) as its authorized official in NPPES: 3 entities in 1 state, paid $1000K combined.
28Combined paid$1000K
33Billing entities3
24GClaims79,394
States1
Matched on the name exactly as typed into NPPES. Two different people with the same name will land on the same page.
Box 32 · Location
By state
Box 33 · Billing providers
All entities
| # | Provider | Location | Type | Paid |
|---|---|---|---|---|
| 1 | Widodo & Lee DDS a Professional Dental Corp | Pomona, CA | Dental Clinic/Center | $609K |
| 2 | Lee & Widodo DDS INC | Chino, CA | Dental Clinic/Center | $234K |
| 3 | Andre Widodo DDS a Professional Corporation | El Monte, CA | Dental Clinic/Center | $157K |